STATEMENT: Warning: The Growing Danger of Prescription Drug Diversion
Statement for the Record
House Committee on Energy & Commerce
April 14, 2011
“Warning: The Growing Danger of Prescription Drug Diversion”
As Co-Chairman of the Congressional Caucus on Prescription Drug Abuse, I would like to thank Caucus Co-Chair and Subcommittee Chairwoman Mary Bono Mack for holding this important hearing today. Over a decade ago, prescription drug diversion began to wreak havoc on communities in my region of Appalachian Kentucky. Local hospitals were experiencing more than an overdose per week, families had been overrun by pain pills, and a feeling of hopelessness had begun to pervade the entire region. These powerful drugs intended to manage pain were suddenly creating pain in the form of overdoses, crime and uncontrollable addiction. While the first wave hit Appalachia, this second wave is hitting America. Now the diversion of prescription pills is the fastest growing drug problem nationwide with abuse transcending state lines and socio-economic groups.
Ms. Bono Mack and the Members of the Subcommittee have assembled a talented group of federal policy-makers, state officials and Americans who have experienced first-hand the devastation wrought by the illicit diversion and abuse of these otherwise life-saving drugs. Today’s testimonies and the ensuing discussions will accomplish more than simply identify the tremendous scope of the problem and the dire implications for the next generation of Americans. I hope this hearing will facilitate ongoing conversations and enhanced collaboration among federal, state and local officials, advocacy organizations around the country, our health and law enforcement communities, and the men and women suffering or recovering from abuse about solutions.
Now that the nation’s attention has been turned to this epidemic, it is time to employ all of the resources and brainpower at our disposal to approach this challenge from a number of angles – prevention, treatment, education and law enforcement all will play a role in eliminating this scourge for good.
As Governor Beshear alluded in his remarks, state-run Prescription Drug Monitoring Programs (PDMPs) are among the most effective and accessible tools to combat prescription drug diversion and abuse, bridging the gap between legitimate medical need and potential misuse. PDMPs acknowledge that a family doctor, a neighborhood pharmacist and a local law enforcement officer are all critical to keeping these drugs from diversion or abuse. Monitoring programs track vital prescription data so that doctors and pharmacists know when a prescription is being abused and investigators can root out bad doctors who are aiding drug dealers and addicts.
In the Commonwealth, the Kentucky All Schedule Prescription Electronic Reporting System (KASPER) has had unprecedented success in bringing this problem under control. In 2008, KASPER processed nearly 418,000 requests for patient prescription information. Of the 94% which came from the medical community, including physicians, ER doctors and pharmacists, nearly three-quarters of them say KASPER is “important” in helping to ascertain patient intentions and patterns, and to feel comfortable writing prescriptions for patients truly in need of medical attention. In the same year, just over 11,000 KASPER requests came from the law enforcement community, and 96% of these KASPER users agree that the PDMP is an excellent tool for obtaining evidence in criminal investigations.
These reports create informed decision-making for good medicine and good law enforcement. I have heard anecdotally of countless occasions where KASPER has helped a doctor provide better patient care or a law enforcement official interrupt a crime. Since 2002, the U.S. Department of Justice Prescription Drug Monitoring Grant Program has awarded over $55 million to nearly every state to plan, implement and enhance similar state-run programs. Because of these efforts, thirty-three other states are catching on with operational PDMPs. Nearly every other state, including three this year alone (Arkansas, Maryland, Montana), has passed authorizing legislation. Nationwide, since 2003, there has been a 2,596% increase in the number of prescription reports produced by state-run PDMPs annually. Important steps have recently been undertaken to facilitate interstate data exchange among these programs to reduce the doctor shopping we’re experiencing, such as that between Florida and Kentucky.
Of note, I have expressed my continued frustration that an inordinate number of the drugs on Kentucky Main Streets are heralding from South Florida. In the first six months of 2010, 41.2 million doses of oxycodone were prescribed in Florida, whereas the total prescribed doses of oxycodone in every other state combined was 4.8 million. In other words, almost 90% of the oxycodone prescribed in the U.S. is ordered by Florida physicians. Last month, as a part of “Operation Pill Nation,” DEA in Florida arrested 22 people and seized over $2.5 million in assets during a takedown of rogue pain clinics. These arrests resulted from 340 undercover buys of prescription drugs, from over 60 doctors in more than 40 “pill mills.” With impressive strides being made to enhance the PDMP model and integrate data-sharing, Florida’s participation will be vital to the success of our nation in fighting this problem, helping addicts get treatment and prosecuting pushers. We need to shut down this pipeline across state lines, and I am heartened by recent news that the state is moving forward with its PDMP. In addition, I am proud to support legislation sponsored by Congressman Vern Buchanan of Florida that would employ the full gamut of federal resources to crack down even more aggressively on these pill mills.
While monitoring programs provide our medical and law enforcement communities with an important tool to identify abuse and diversion, buy-in from local communities might be the single most important factor in developing an anti-drug culture in towns across the country. I was proud to welcome Office of National Drug Control Policy (ONDCP) Director Gil Kerlikowske to my congressional district last month. When I showed him the front page of our local paper, there were some notable omission – no stories about the town fair or the community pot lock. The front page was chalk full of articles about prescription drug abuse – arrests, thefts, the abandonment of children, and tragically, deaths. This is sadly typical in Kentucky, where we are losing 82 people monthly to overdose. To spend a few days in my district, one would think that the situation is truly cyclical and hopeless. However, while I believe the Director has appreciation for the challenges we’re facing with the abuse of these drugs in Kentucky, I don’t think he left with that impression that we can’t pull ourselves out of this mess.
In Eastern Kentucky, we’ve been employing a multi-pronged approach to combating this abuse for years through Operation UNITE. Since inception, more than 4,500 addicts and non-violent offenders who have fallen prey to this scourge have participated in a UNITE-funded drug court or treatment program, restoring hope and creating opportunity. In addition, 188 schools in 36 southern and eastern Kentucky counties have a UNITE club, encouraging our children to remain drug-free and offering counseling programs. There are countless UNITE Community Coalitions throughout my congressional district, which support educational and faith-based conferences, medical symposiums, technical trainings and health care workshops. Many of these coalitions have received federal support through the Office of National Drug Control Policy (ONDCP) Drug-Free Communities Grant program. Operation UNITE is a bright star in our charge to empower our youth, create an anti-drug culture and knock out abuse for good, and a clear indication that our fight against drug abuse is rooted in small communities across the country. I am pleased that Director Kerlikowske had a desire and an opportunity to witness first-hand the positive impact of this program in our region.
Needless to say, we’re positioning ourselves to tackle this issue, both locally and through state-level coordination. I look forward to next Tuesday when ONDCP will join top officials from the Department of Health and Human Services, Food and Drug Administration (FDA), and the Drug Enforcement Administration (DEA) to unveil the Administration’s comprehensive plan for addressing the our fastest growing drug threat. I am encouraged by these important strides to bring relevant and interested stakeholders to the same table to work towards solutions for the short- and long-term. This will take a collaborative, multi-pronged effort -- law enforcement, treatment, education are all a part of the puzzle – and I am grateful to have the opportunity to share my perspective with you in the course of this important hearing.
Thank you all for being here today.