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Government Takes on Doctor Shoppers, Pill Mills

Agencies Combine in National Crackdown

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Updated March 03, 2004

For the first time, the Bush Administration will carry out a coordinated drug strategy to confront the illegal diversion and abuse of prescription drugs.

This week, President Bush's "Drug Czar," John Walters, joined FDA Commissioner Mark McClellan, DEA Administrator Karen Tandy, Surgeon General Dr. Richard Carmona, and Representative Tom Davis to release the President's National Drug Control Strategy, which outlines the extent of prescription drug abuse in the United States and new Federal programs designed to address the problem.

Director Walters said, "The non-medical use of prescription drugs has become an increasingly widespread and serious problem in this country; one that calls for immediate action. The Federal government is embarking on a comprehensive effort to ensure that potentially addictive medications are dispensed and used safely and effectively."

Recent data indicates that prescription drug abuse, particularly of opioid pain killers, has increased at an alarming rate over the last ten years:

  • Non-medical use of narcotic pain relievers, tranquilizers, stimulants, and sedatives ranks second (behind marijuana) as a category of illicit drug abuse among adults and youth;

  • In 2002, 6.2 million Americans were current abusers of prescription drugs; 13.7 percent of youth between the ages of 12 and 17 have abused prescription drugs at least once in their lifetimes; and

  • Emergency room visits resulting from narcotic pain relievers abuse have increased 163 percent since 1995.

  • More than 10 million Americans suffer from chronic pain. The Strategy seeks to balance the need for effective pain management therapies with the prevention of misuse, abuse, and diversion of psychotherapeutic drugs.

"Many Americans benefit from the appropriate use of prescription pain killers, but, when abused, they can be as addictive and dangerous as illegal drugs," Health and Human Services Secretary Tommy G. Thompson said. "This new, coordinated Federal initiative will help us stop and prevent prescription drug abuse, and the harm it can cause."

The National Drug Control Strategy brings the efforts of the Food and Drug Administration (FDA), federal substance abuse prevention and treatment agencies, and law enforcement to bear on the factors contributing to rising prescription drug abuse. The Strategy incorporates education of medical professionals and consumers, outreach to businesses involved in Internet commerce, pharmaceutical manufacturers, and pharmacies, as well as increased investigation and enforcement activities. New programs include:

  • Careful consideration of labeling and commercial promotion of opiate drug products;

  • Ensuring wider dissemination of education and training on appropriate pain management and opioid treatment procedures for physicians authorized to prescribe controlled substances;

  • Increasing the number of state Prescription Monitoring Programs, which detect suspicious prescriptions and individuals redeeming prescriptions from multiple physicians ("doctor shopping") to identify abusers; and

  • Using web crawler/data mining technology to identify, investigate and prosecute "pill mills" - Internet pharmacies that provide controlled substances illegally.

"When used correctly, opioids play a very important role in the management of pain. FDA's job is to maximize the potential benefits that patients receive from these drugs, while, at the same time, minimizing the risks associated with these products," said FDA Commissioner Mark B. McClellan, M.D., Ph.D.

The Drug Enforcement Administration (DEA), in conjunction with the FDA, will implement additional investigative efforts and enforcement actions against the illegal sale, use, or diversion of controlled substances, including those occurring over the Internet.

"Criminals who divert legal drugs into the illegal market are no different from a cocaine or heroin dealer peddling poisons on the street corner," said DEA Administrator Karen Tandy. "DEA is aggressively working to put an end to this illicit practice whether it occurs in doctors' offices or cyberspace, and ensure the integrity of our medical system."

Because agencies, organizations, and individuals at the state and local level are uniquely positioned to quickly identify and respond to prescription drug diversion and abuse trends, the Strategy seeks to create and extend collaborative efforts outside of the Federal government.

"Drug abuse, in all its forms, is a societal issue that demands societal solutions," Surgeon General Richard H. Carmona said. "By engaging health professionals, families, and support groups we can provide assistance to people of all ages and from all walks of life who may be at risk, and help those who have already fallen victim to an addiction recover."

The President's 2005 budget requests $138 million for diversion control programs. The National Drug Control Strategy seeks to reduce illegal drug use by 10 percent in two years and by 25 percent in five years.

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