Pubdate: Tue, 2 Mar 2004
Source: Washington Post (DC)
Copyright: 2004 The Washington Post Company
Page: A09
Author: Marc Kaufman, Washington Post Staff Writer
Bookmark: ( Chronic Pain )
Bookmark: (Walters, John)


U.S. Officials Want Better Monitoring, Control of Painkillers

The Bush administration unveiled an expanded crackdown yesterday on
what it called the growing menace of prescription drug abuse, which it
said now touches and harms more than 6 million Americans yearly.

Top administration officials said the initiative, the first
comprehensive one of its kind, would increase state monitoring
programs that detect suspicious prescriptions and patients suspected
of doctor shopping, and would seek to better educate doctors about how
to detect potential abusers of prescription drugs.

It will also take on the burgeoning use of the Internet to purchase
controlled drugs. Karen Tandy, head of the Drug Enforcement
Administration, said in a news conference that thousands of Web sites
pop up regularly offering narcotic medications, often without a
prescription or a visit to a doctor. She said it has been very
difficult to move against them because they shut down as soon as they
are identified, and then reopen under a different name.

"The non-medical use of prescription drugs has become an increasingly
widespread and serious problem in this country," said "drug czar" John
P. Walters, director of the White House Office of National Drug
Control Policy. "The federal government is embarking on a
comprehensive effort to ensure that potentially addictive medications
are dispensed and used safely and effectively."

Walters said that under President Bush's proposed 2005 budget, funds
to attack the illicit use of prescription drugs would increase by $20
million, to $138 million. Most of the money would be directed at
reducing the abuse of opium- and morphine-based painkillers, which are
among the most widely prescribed medications.

The issue of how painkillers such as OxyContin, Lortab and Vicodin are
prescribed and used has become an increasingly contentious one. Some
pain doctors and law enforcement officials have come into sharp
conflict over how widely and readily they should be available.

The Drug Enforcement Administration and Justice Department have become
more aggressive in targeting and prosecuting doctors and pharmacists
who they say are improperly prescribing and distributing prescription
narcotics, and dozens of health practitioners have been charged in
recent years in connection with their prescribing practices. Several
are in prison.

Pain doctors and some advocates for patients with chronic pain say the
government has become overzealous and has created a "chilling effect"
that keeps many doctors from prescribing painkillers that patients
need. They argue that the more pressing problem regarding painkillers
is that so many patients in pain are not getting them.

"Doctors who prescribe opioids for pain are becoming increasingly
intimidated by the government's targeting of legitimate medicine,"
said Siobhan Reynolds, an advocate with the Pain Relief Network. "We
implore our elected representatives to put the needs of ill Americans
ahead of the reckless demands of misguided and self-serving government

In describing why the administration is making the diversion of
prescription drugs a priority, officials presented statistics
indicating that although illicit drug use is declining overall, the
abuse of prescription drugs is increasing.

According to a 2003 University of Michigan study, for instance, the
painkiller Vicodin was second only to marijuana in illicit use by
12th-graders. Federal statistics estimated that 6.2 million Americans
misused prescription drugs in 2002, compared with 2 million who used
illegal cocaine and 700,000 who used ecstasy.

A new study by the National Center on Addiction and Substance Abuse at
Columbia University identified 495 Web sites advertising controlled
prescription drugs during a one-week analysis. Of those, 157 were
sites that sold opioid-based drugs such as OxyContin, Percocet and
Darvon. Only 6 percent of the sites selling drugs required a
prescription, the study found, and none took steps to prevent the sale
of drugs to children.

In an effort to combat the Web sites, the DEA said it would use
Web-crawler and data-mining technology to identify and prosecute the
operators of the Web sites. Walters said the administration also will
pressure credit card companies and mail delivery services to deal more
seriously with the illicit sale of prescription narcotics, stimulants
and depressants.

Rep. Thomas M. Davis III (R-Va.), chairman of the House Government
Reform Committee, said at the news conference that his committee is
putting together a bipartisan bill that would make it easier to attack
rogue Web sites.

As an important part of its attack on illicit prescription drug use,
Walters said, the federal government wants to increase from 20 to 31
the number of states that have "prescription monitoring programs."
These plans can detect individuals who are redeeming prescriptions for
controlled drugs from multiple doctors, and can highlight suspicious
- ---
MAP posted-by: Richard Lake