Pubdate: Mon, 14 Mar 2011
Source: Macon Telegraph (GA)
Copyright: 2011 The Macon Telegraph Publishing Company
Author: Halimah Abdullah


WASHINGTON -- It's called the "pill mill pipeline" -- an underground
prescription drug network that weaves its way up from pain clinics on
Florida's sunny shores to the Appalachian mountain communities and is
now seeping into rural Georgia enclaves and towns just outside of
larger cities.

The selling of what is known as "hillbilly heroin," or OxyContin, has
spread rapidly in part because of the fact that Georgia is the only
Southern state that has not yet enacted legislation for a prescription
drug monitoring program to track the drugs, according to the Alliance
of States with Prescription Monitoring Programs, but is one of seven
states that has such legislation pending.

Florida is one of seven states nationally that have enacted
prescription drug monitoring legislation but don't have the programs
operational yet.

In some cases, prescriptions are being written by doctors in places
such as Middle Georgia and filled in Alabama and South Carolina, said
John Horn, first assistant U.S. attorney in Atlanta.

"Our office is absolutely concerned that Georgia is seeing an increase
in pill mills, and we do believe the increase is tied to the fact that
our neighboring states have monitoring programs," Horn said. "A
monitoring program is a way to identify where to address the problems,
but it also has a deterrent effect on those who would come to Georgia
to obtain drugs illegally."

There are several measures in the state Legislature to create a
monitoring system, and the Georgia Senate recently voted to create a
database that would flag patients who "doctor shop" by trying to get
multiple prescriptions for pain pills and also flag the doctors and
pharmacists who repeatedly fill those requests.

Lawmakers in other states hope Georgia officials take

Kentucky officials consider their state a cautionary tale of sorts.
Kentucky Rep. Hal Rogers' voice grows tight with frustration whenever
he talks about the prescription drug epidemic that's gripped
Appalachia for more than a decade.

"Crook doctors operating these pill mills" in Florida are running
rampant and are fueling the flow of illegally obtained prescription
drugs to states like Kentucky, Rogers told Attorney General Eric
Holder during a recent hearing.

"My people are dying," the chairman of the House Appropriations
Committee said.

For Kentucky lawmakers such as Rogers, who've long been on the front
lines battling an epidemic of pain-pill abuse, the battle feels personal.

While Rogers appreciates the administration's current efforts, he says
the problem was ignored for far too long on the federal level. More
needs to be done, he says.

The White House "has got to act," Rogers said. "We've got more people
dying of prescription drug overdoses than car accidents."

The Obama administration counters that it is the first to publicly
call the prescription drug abuse problem an epidemic and says it has
stepped up drugs busts and directed millions in funding to
state-operated prescription monitoring programs.

White House drug czar Gil Kerlikowske called Thursday for a
multi-pronged approach to fight the problem.

Kerlikowske spoke to members of the Congressional Caucus on
Prescription Pill Abuse and stressed the need for stronger law
enforcement, education and prescription drug monitoring to help combat

In the meantime, Rogers hopes legislation he's co-sponsoring with Rep.
Vern Buchanan, R-Fla., calling for a tougher federal crackdown on pain
clinics that dispense prescription drugs will help stem the flow of
drugs across all state lines.

The measure includes provisions to support state-based prescription
drug monitoring programs; to use the money from seized illicit
operations for drug treatment; to strengthen prescription standards
for certain addictive pain drugs; and to toughen prison terms and
fines for pill mill operators. As of Friday, Buchanan's staff was
reaching out to Georgia lawmakers and others to co-sponsor the bill.

The measure comes on the heels of Florida Gov. Rick Scott's calls to
repeal a monitoring program designed to stem interstate prescription
drug trafficking -- a move White House officials say will stymie
efforts to curb the problem.

Scott has cited concerns about costs and patient privacy rights and
has since turned down a $1 million donation from pharmaceutical giant
Purdue Pharma, the maker of OxyContin, to help pay for a prescription
database to combat Florida's illegal trade in painkillers. Despite
some success, including several high-profile drug busts and the
adoption of prescription drug monitoring programs in 43 states, the
problem is now so entrenched that the cheap flights and van rentals
drug traffickers use to travel from Florida, through Georgia and up
the East Coast to peddle "hillbilly heroin" are nicknamed the
"OxyContin Express."

During the past decade, the study by the Substance Abuse and Mental
Health Services Administration found a fourfold increase nationally in
treatment admissions for prescription pain pill abuse. The increase
spans every age, gender, race, ethnicity, education, employment level
and region.

The study also shows a tripling of pain pill abuse among patients who
needed treatment for opioid dependence.

"The extent of the problem is statewide," Horn said. When we see
"prescriptions being written by a doctor in Georgia and filled in
Alabama and South Carolina, the inference is that there are doctors in
places like the Macon and Columbus (metropolitan areas who) are
writing those prescriptions." 
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