Pubdate: Tue, 2 Mar 2004 Source: Washington Post (DC) Copyright: 2004 The Washington Post Company Page: A09 Contact: http://www.washingtonpost.com/ Details: http://www.mapinc.org/media/491 Author: Marc Kaufman, Washington Post Staff Writer Bookmark: http://www.mapinc.org/find?232 ( Chronic Pain ) Bookmark: http://www.mapinc.org/people/Karen+Tandy Bookmark: http://www.mapinc.org/walters.htm (Walters, John) CRACKDOWN ON PRESCRIPTION ABUSE 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 bureaucracies." 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 prescriptions. - --- MAP posted-by: Richard Lake