Pubdate: Wed, 20 Mar 2013
Source: Bluefield Daily Telegraph (WV)
Copyright: 2013 Bluefield Daily Telegraph
Author: Charles Owens
Page: A1


Sen. Joe Manchin Looks to Re-Introduce the 'Safe Prescribing Act of 2013'

WASHINGTON - When he met with children at a small Wyoming County 
middle school in late 2011, U.S. Sen. Joe Manchin was moved by the 
stories of families ruined by prescription drug addiction.

"They lost everything - they lost their home. They lost their 
families," Manchin, D-W. Va., said of the stories that emerged from 
the Oceana Middle School meeting. "These were 11-and 12-yearold boys 
and girls begging for help. They were asking for help. They were 
basically saying we've lost our community and our town due to this 
epidemic of drug abuse. Yes it (the visit) impacted me."

The troubling stories shared by the children was one of the reasons 
Manchin attempted in 2012 to pass legislation aimed at placing 
tighter restrictions on drugs containing hydrocodone. That bill made 
it through the Senate, but ran into opposition in the House where it died.

Manchin, and a bipartisan group of lawmakers, will formally 
re-introduce the "Safe Prescribing Act of 2013" today.

Manchin is co-sponsoring the resurrected measure with U.S. Sen. Mark 
Kirk, R-Ill., U.S. Rep. Vern Buchanan, R-Fla., and U.S. Rep. Edward 
Markey, DMass. The legislation seeks to re-classify hydrocodone 
combination products as schedule II controlled substances. 
Hydrocodone combination products are currently classified as schedule 
III drugs.

"This piece of legislation has the endorsement and support of 
bipartisan Democrats and Republicans," Manchin said. "They know by 
putting hydrocodone as a schedule II it gives us a heck of a chance 
to start fighting this on a more level playing field."

Manchin said the number of citizens in West Virginia to die from drug 
overdoses has increased by an alarming rate over the last two years.

"I think this is why we are getting the broad-based support," Manchin 
said. "I will do everything I can on the federal level to fight this 
war on drugs."

When the measure was first introduced in 2012, it ran into opposition 
from lawmakers in the U.S. House of Representatives who heard from 
pharmaceutical companies and drug distributors. Since that time, 
efforts have been made by Manchin and other lawmakers to reach out to 
those who opposed the bill a year ago, and to explain how the measure 
would not keep patients with legitimate medical needs from receiving 
hydrocodone-containing narcotics.

"Basically, you had a lot of pharmaceuticals to push back and drug 
distributors to push back," Manchin said. "I went and talked to all 
of them. We never let up. We stayed right at it. I looked at all of 
them and said 'is there not anyone sitting in the room, and not 
sitting on the panel, who has not been affected (by prescription drug 

The proposed legislation also would require the Government 
Accountability Office to conduct an oversight study on how the change 
impacts legitimate use of pain medication, particularly for patients 
in rural areas and nursing homes.

Manchin said the current schedule III classification of hydrocodone 
perpetuates the misconception that the combination products are less 
potent and less habit-forming and therefore less dangerous than 
oxycodone combination products. "In truth, they have proven to be 
just as dangerous when not used properly," Manchin said.

Manchin said many physicians, law enforcement groups, addiction 
specialists and others have expressed support for the movement to re- 
classify hydrocodone combination products to a schedule II.

Area law enforcement officials Tuesday said the proposed legislation 
would help.

"It will be a step in the right direction," Sgt. Hose Centeno of the 
West Virginia State Police said. "I agree with Mr. Manchin. But the 
problem we have is that drugs like water will find a path of movement."

Centeno, commander of a local southern West Virginia drug task force, 
said hydrocodone is currently preferred by drug dealers because of 
its current schedule III classification.

"Where a schedule II controlled substance is more expensive in street 
value, the hydrocodone is more affordable on the streets," Centeno 
said. "Hydrocodone, although it is a very strong narcotic, has proven 
to be highly addictive, and preferred by most of the drug users. In 
time, they turn to these drug dealers, and when we arrest them they 
explain they also resort to hydrocodone because it is less expensive 
and more easier to be found."

Centeno said the proposed law would also send a message to the local 
medical community.

"When I say I think this is a step in the right direction, it is 
because this will send a message to the responsible physicians," 
Centeno said. "When a drug is not working for their patients, there 
is always different alternatives to treating pain that may not 
necessarily involve narcotics. But if it involves a narcotic they 
have to treat it with the seriousness that is required by the public. 
The recklessness of some physicians that we've been able to detect 
and prosecute tells us there may be some criminal element involving 
medicine and that has no legitimate purpose in society."

But the prescription drug epidemic extends far beyond just the 
mountains of southern West Virginia. In neighboring Southwest 
Virginia, Tazewell and Russell counties are currently number one and 
two in the Commonwealth in per capita accidental overdose deaths. 
Tazewell County Commonwealth Attorney Dennis Lee believes the new 
legislation will help.

"We see as much abuse of hydrocodone, if not more, from the schedule 
II narcotics such as oxycodone," Lee said. "Although the strength of 
the drug may be less than oxycodone, it is abused at a far greater 
rate than what we see as oxycodone. Changing the schedule will do a 
number of things. One, it will require doctors to see patients they 
prescribe hydrocodone to on a more frequent basis to monitor their 
usage and give them drug screens and follow ups. Number two, in 
Virginia that would increase the punishment for the distribution of 
the drug quite significantly because right now to sell a schedule III 
drug such as hydrocodone carries a maximum sentence of up to five 
years. This would take it up to 40 years if it becomes a schedule II. 
Also, from the standpoint of public health the amount of overdose 
deaths involving hydrocodone is year in and year out the top two or 
three causes. Usually it is methadone, hydrocodone and oxycodone. 
Basically that is the three drugs that our overdose deaths are 
attributed to. And there have been years where hydrocodone has been 
the number one cause of overdose deaths."

With the current schedule III classification, Lee said patients using 
hydrocodone can go for months without having to see a doctor, and can 
receive multiple refills.

"With schedule II drugs you are required to have consultations with 
your doctor on a more regular basis," Lee said. "They will be 
required to see the person and have consultation with them on a monthly basis."

Lee said doctor shopping by those drug dealers who travel out of town 
to receive pain pills, and those who operate socalled "pill mills," 
are still a huge problem for Southwest Virginia.

"I say the majority of the pills being sold on the streets in 
Southwest Virginia right now are coming from out-of-state doctors and 
pain clinics that are no more than pill mills," Lee said. "I'm not 
saying all of the pain clinics are illegitimate, but there are a 
number (of problems)."

Lee said he hopes Manchin's bill passes the U.S. Senate for the 
benefit of Southwest Virginia.

Manchin said the Drug Enforcement Agency classifies drugs based on 
their abuse potential and addictive nature.

"The high potential for addiction and abuse posed by hydrocodone 
combinations indicates that they are currently misclassified as 
schedule III products," Manchin said. "This misclassification sends 
the wrong message to patients and providers that these painkillers 
are less dangerous or less powerful than their schedule II counterparts."

The legislation will not restrict access for patients with legitimate 
medical needs, according to Manchin. "It appropriately regulates 
these powerful painkillers to reflect their high potential for abuse 
while accommodating patients with legitimate medical needs."
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MAP posted-by: Jay Bergstrom