White House Announces New Prescription Drug Abuse Plan

U.S. Drug Czar Gil Kerlikowske today unveiled the White House's new action plan to control prescription drug abuse. The press release is here. Background here.

The plan is here. There are four components: education, tracking and monitoring, proper disposal, and enforcement. [More...]

Under "tracking and monitoring", the plan notes that 43 states have prescription monitoring database plans but only 35 are operational. Some good news: It says PDMP data cannot be used in court.

As to enforcement, there will be greater information sharing among federal, state and local law enforcement, particularly DOJ, DEA, HHS and State Medical Boards. The feds will continue to "aggressively" pursue "pain clinics and prescribers who are not prescribing within the usual course of practice and not for legitimate medical purposes.

  • Increase HIDTA intelligence-gathering and investigation of prescription drug trafficking, and increase joint investigations by Federal, state, and local agencies
  • Identify and seek to remove administrative and regulatory barriers to “pill mill” and prescriber investigations that impair investigations while not serving another public policy goal. (ONDCP/ DOJ/DEA/HHS/FDA)
  • Expand the use of PDMP data to identify criminal prescribers and clinics by the volume of selected drugs prescribed. Encourage best practices for PDMPs, such as PDMP reporting of such prescribers and clinics to pharmacies, law enforcement, and insurance providers. (DOJ/DEA)
  • Use PDMP data to identify “doctor shoppers” by their numbers of prescribers or pharmacies. Encourage best practices such as identifying such individuals to their prescribers and pharmacies, law enforcement and insurance providers. (DOJ/BJA)
  • Increase by 25 percent the number of HIDTAs involved in intelligence gathering and investigation around prescription drug trafficking and participation on statewide and regional prescription drug task forces within 24 months;

The five year goal: a "15 percent reduction in non-medical use of prescription-type psychotherapeutic drugs in the past year among people 12 years of age and older."

The FDA's Opioid Drugs and Risk Evaluation and Mitigation Strategies (REMS) is here.

Obama's proposed 2012 Drug Enforcement Control budget is here. The DEA's proposed 2012 budget is here. For the DEA's Diversion Control (prescription drug) program:

DEA requests 124 positions, including 50 Special Agents, 50 Diversion Investigators, and 9 Intelligence Analysts, and $30,885,000 to support regulatory and enforcement activities of the Diversion Control Program. This request includes $9,393,000 in non-personnel funding for rent, task force officer overtime, administrative support, and training for Tactical Diversion Squads (TDS). These resources will support DEA’s efforts to fulfill both the regulatory control and enforcement aspects of the Diversion Control Program.

Diversion budget, just for the DEA: $322 million. (page 22.)

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    Still no concern for OTC abuse (5.00 / 1) (#1)
    by Big Tent Democrat on Tue Apr 19, 2011 at 01:24:15 PM EST
    Incredible how the nutritional supplement business has simply been ignored by the government.

    Too bust witchunting Barry Bonds apparently.

    Two points about that (none / 0) (#2)
    by andgarden on Tue Apr 19, 2011 at 01:49:59 PM EST
    First, it's not quite fair. Lots of OTC cr@p has been taken off the market by the FDA over the last ten years.

    Second, voters like "herbal, natural" products. That's how the DSHEA got through Congress in 1994.


    No offense to you (none / 0) (#6)
    by Big Tent Democrat on Tue Apr 19, 2011 at 02:25:38 PM EST
    bt I can assure you that the FDA has done an absolutely terrible job from my extensive personal experience of the last 15 years.

    I guess my first point was a little glib (none / 0) (#7)
    by andgarden on Tue Apr 19, 2011 at 02:38:09 PM EST
    I do know that there are way too many ads for weight loss "supplements" that have the "not intended to treat" fine print. But I think a big part of the problem is that people LIKE having access to these things. They might well prefer OTC amphetamine instead, but the "natural supplement" distinction seems to allow the intellectual inconsistency.  

    Leaving aside the nutritional supplements (none / 0) (#4)
    by Zorba on Tue Apr 19, 2011 at 01:57:48 PM EST
    for the moment (and you're right, they need to be tested and regulated- they're not all benign), Mr. Zorba (a molecular biologist) is far more worried about acetaminophen overdose.  Tylenol is in so many OTC multi-symptom drugs that, if you also pop a couple of Extra-Strength Tylenol, you're in danger of damaging your liver.  Especially if you drink alcohol.  Link  

    They Purposly Put... (5.00 / 1) (#10)
    by ScottW714 on Tue Apr 19, 2011 at 03:15:57 PM EST
    ... acetaminophen in cough syrup so people will get ill rather than high.  Maybe 5 years ago I was trying to find some cough syrup w/o acetaminophen because of the harmful effects and after reading a zillion bottles and coming up empty, I looked into it.  

    If memory serves me correctly I was looking for another active ingredient (can't remember now) and realized the two were never sold apart and it was done on purpose.  


    They do the same (none / 0) (#15)
    by Zorba on Tue Apr 19, 2011 at 03:42:42 PM EST
    for pretty much all the related versions of codeine.  The oxycodones.  The hydrocodones.  Try to find one without acetaminophen- good luck.  They do it for the same reason- to make people very ill, so they won't use the drug to get high.  (You can get codeine and related substances with ibuprofen instead, but you have to insist and practically nag your doctor into it.  Most doctors just automatically prescribe codeine with acetaminophen.)

    So Better to Get... (5.00 / 2) (#21)
    by ScottW714 on Tue Apr 19, 2011 at 04:14:43 PM EST
    ... a law abiding citizen ill/damaged liver, then to let a drug abuser get away with abusing their own body.

    It what fricken planet does this make sense ?

    Not sure if they still do this, but in the 80's they would spray weed crops with some chemical that was very bad for people.  So instead of letting people abuse their own bodies, the governemnt was doing it for them on a much grander scale.

    But even that draconian approach didn't effect non-users, unlike the acetaminophen.  Which they are essentially using as a poisoning agent to ward off possible abuse.

    I would love to be privy of one of these meetings, when Dumbass X busts out his great new idea, then hear him/her defend it when some one mentions that everyone in the room uses these products (as well as their families), they want to poison.


    The chemical was Paraquat (5.00 / 0) (#29)
    by jeffinalabama on Tue Apr 19, 2011 at 05:15:25 PM EST
    A dessicant, if it's a sunny day, you can see the plant begin to shrivel in minutes. Now it's available as Gramoxon, and It's a class 1 poison... very dangerous, even when diluted.

    Ah, yes (none / 0) (#32)
    by Zorba on Tue Apr 19, 2011 at 05:38:59 PM EST
    I do remember this.

    Of course it doesn't (none / 0) (#27)
    by Zorba on Tue Apr 19, 2011 at 04:39:39 PM EST
    make any sense.  Better, in their thinking, I guess, to have someone in pain from chemotherapy or something else horrible, potentially blow up his liver, than to let someone get high off of a prescription pain killer.  It boggles the mind.  Our so-called "War on Drugs" is really a war on the American people.  It is, as you said, draconian.

    I rue the day that the FDA (none / 0) (#8)
    by BackFromOhio on Tue Apr 19, 2011 at 02:54:54 PM EST
    gets more heavily into nutritional supplements. Remember the time when L-Tryptophan was pulled off the market as dangerous, when it was some badly manufactured strains that were the problem?  The FDA and the traditional medical profession know so little about nutritional supplements, that I think they will do far more harm than good, and end up taking actions that force people to pay for expensive prescription drugs to treat conditions that can be effectively and far more safely handled by non-prescription means.

    Not all the nutritional supplements (5.00 / 1) (#17)
    by Zorba on Tue Apr 19, 2011 at 03:58:35 PM EST
    are benign.  Look up red yeast rice, niacin, kava, and any number of other "natural" supplements.  I take supplements myself.  But just because it is "natural" does not make it "safe."  We need to do a much better job of testing nutritional supplements (as well as prescription drugs and OTC medicines, for that matter).  And we need to do our homework before using the supplements (or any medicine).  The European Union does a much better job of testing and certifying nutritional supplements than we do.  I wish we would do the same.  (And I don't necessarily trust the FDA's findings that any prescription, or for that matter, OTC drug, is "safe."  They rely way too much on the research of the drug companies themselves.)    

    I agree with you (none / 0) (#22)
    by BackFromOhio on Tue Apr 19, 2011 at 04:16:11 PM EST
    but I'm wary of authorization to effect quality control becoming the basis for pulling nutrients off the market.  Alcohol is toxic, but sold OTC, as are cigarettes, so why are nutrients so high on everyone's watch list?  Even meat, milk products, etc. pumped with antibiotics and hormones are not without their dangers.

    Because (none / 0) (#24)
    by Zorba on Tue Apr 19, 2011 at 04:30:52 PM EST
    booze and cigarettes are making a lot of people a whole lot of money.  And the hormones and antibiotics pumped into our food animals increase profits for Agribusiness.  It's all about the Benjamins.  I'm pretty much in favor of letting people ingest whatever the heck they want, but I would like some really good information out there so that people can make educated choices about what they put into their bodies (and so that they can have a reasonable number of choices and not depend only upon the stuff that they can buy at their local Walgreen's or Safeway).

    I totally disagree with you (none / 0) (#9)
    by andgarden on Tue Apr 19, 2011 at 03:08:59 PM EST
    There is no difference in principle between drugs and nutritional supplements.

    Does your opinion extend to (none / 0) (#11)
    by oculus on Tue Apr 19, 2011 at 03:16:59 PM EST
    "medical" mj?

    Yes (none / 0) (#12)
    by andgarden on Tue Apr 19, 2011 at 03:28:08 PM EST
    I'm not saying you shouldn't be allowed to have it. But I am also not willing to engage in the fiction that it exists in some different intellectual reality from FDA regulated drugs.

    What "principle" are (none / 0) (#20)
    by BackFromOhio on Tue Apr 19, 2011 at 04:12:29 PM EST
    you referring to?

    Nutritional supplements (none / 0) (#26)
    by andgarden on Tue Apr 19, 2011 at 04:34:41 PM EST
    are taken like drugs--they almost all are drugs--, and should be so regulated. (Note: that doesn't mean that I think drugs are regulated well).

    At the risk of (none / 0) (#34)
    by JamesTX on Tue Apr 19, 2011 at 05:46:47 PM EST
    offending those who swear by supplements, the difference between marijuana and opioids on the one hand, and most herbals on the other, is that marijuana and opioids actually work -- they actually do something which makes large numbers of people feel better. They are therefore competition where most herbals are not. There is no sense in wasting money tilting at windmills. But give people morphine, or marijuana, and they will stop feeding money into the pharma industry and the medical technology industry at an alarming rate.  That may sound like bad news to some, but not everyone is convinced all the new patented drugs and machines are doing that much for us. One thing they are doing for sure is making a few people very, very rich.

    I don't see any requests for qualified medical (5.00 / 2) (#3)
    by republicratitarian on Tue Apr 19, 2011 at 01:56:04 PM EST
    personnel or doctors on that list anywhere.

    Is this another case of the government deciding it knows better than you or your doctor?

    Yes, I was wondering (5.00 / 2) (#5)
    by Zorba on Tue Apr 19, 2011 at 02:02:23 PM EST
    who decides what is "the usual course of practice and not for legitimate medical purposes."  If I were an MD, I'd be worried about getting caught in the Fed net for prescribing pain meds to my patients in chronic, excruciating pain.  What may be a "usual" dose for the average patient in temporary pain is often not enough to give any kind of relief for high-levels of chronic pain.

    One thing that scares me about all this (5.00 / 1) (#40)
    by Militarytracy on Tue Apr 19, 2011 at 10:26:59 PM EST
    Memorial hospital in Colorado Springs was going through some new program of not "over medicating" children when Joshua had his first clubfoot surgery.  Wow that surgery was extensive too, you can't imagine, and when he came out his feet were in huge casts that were changed two weeks later when swelling went down.

    When he woke from surgery he was in pain but under their new plan of treatment he wasn't in "enough" pain to administer pain meds.  When he was in "enough pain" to ask for a doctors order it took hours to get the order and then get the pain meds from the hospital pharmacy.  By the time they got there and gave it too him I had been dissolved into a trembling nervous wreck of tears and Joshua had beaten one of his freshly reconstructed casted feet against the side of the bed so hard he had dislodged a pin from his toes and it flew across the room.  One of his feet has toes slightly more slanted to the side than the other one from that pin becoming dislodged and flying across the room.  The doctor said it wasn't worth the pain it would cost him to try to put it back in.


    I really hate the whole... (5.00 / 2) (#41)
    by MileHi Hawkeye on Tue Apr 19, 2011 at 11:00:53 PM EST
    "rate your pain on a scale of 1 to 10" thing.  Pretty hard thing to quantify when one is in pain! Let's see, I hurt like heck and I'd like it to stop, so I'll say 10.  

    When I was Josh's age, you didn't even want to be on the same floor as me when the meds wore off after surgery!  Suffice to say I was a bit of a terror...


    When you are kid in such situations (none / 0) (#43)
    by Militarytracy on Tue Apr 19, 2011 at 11:16:48 PM EST
    What do you get to control?  Nothing.  I keep that in mind now that he is older, but still not old enough to not be at the mercy of everyone....he can only let us know how much it sucks and how much we all suck too sometimes.

    Similar situation (5.00 / 1) (#45)
    by sj on Wed Apr 20, 2011 at 12:46:41 AM EST
    When my son was 9 he was struck by a car and spent nearly 6 weeks in the hospital with his arm and leg in traction.  For 6 weeks his leg was in a knee-bent position.  At that point he went into surgery, they removed all the pins which his muscles had "adapted" to, and put him in a cast from torso to ankle with a straight leg position (very similar to this).  I stayed with him post-op but had to leave when visiting hours were over.  I thought that was okay because he was sleeping when I left.

    When I got home the phone rang -- it was the nurse calling from his room.  He'd awakened screaming with pain and they "couldn't" give him any more pain medication.  I didn't have a car and quickly getting back at that hour using PT wasn't possible.  I had to talk him down over the phone and managed to get him calm enough that he could at least fall asleep from exhaustion.  It took a couple of hours.  

    I didn't dare hang up and take a chance on waking him with the phone off the hook tone.  So I stayed on for at least another hour til a nurse came back into the room and hang up the phone for me.  I was so shaken by his trauma and listening to his deep sobs and moans in his sleep that my arms and legs didn't work.  It breaks my heart and makes me angry to this day.


    I just watched the (5.00 / 0) (#46)
    by JamesTX on Wed Apr 20, 2011 at 01:55:04 AM EST
    press conference on CSPAN. Like the congressional hearing the other day, it looks like they are going to make absolutely shameless use of the grieving mothers and fathers of young OD victims. I don't see any reason why they had the press present, anyway. They didn't answer any questions which didn't fit the party line. To match these parent's sad stories (and they are sad -- it's just that this is not the solution and this will not solve those problems), they need to hear the story of Siobhan Reynold's husband's death because he couldn't get pain treatment. He died in a hotel room from a stroke caused by high blood pressure due to pain. Chronic pain kills, in more ways than one. It is a deadly disease process. People suffering from untreated pain have families who grieve also.

    We only got one good question fired off at first by the DPA guy. He asked them what they would be spending to be better prepared to respond to OD emergencies. Of course, since they aren't doing this to save lives, they didn't have an answer.

    The only other relevant question seemed to be how this would effect the Hispanic community. The response was that there are many Hispanics who abuse drugs. Of course, the real answer is, it will disproportionately effect minorities with high poverty rates through the mechanism intended. They will be less likely to have their pain treated. In short, they will hurt more.

    What is seriously needed here is more widely distributed stories like your's and MilitaryTracy's -- not to mention the the really sad ones where otherwise productive people slowly succumb to chronic pain and die from the stress (after being impoverished by the medical system).

    The only honest statement made in the whole thing was the comment by Gil Kerlikowske that this was the right thing to do for the medical professionals and the pharmaceutical companies. He gave off a sort of embarrassed grin after he said that, as if he realized he had spilled the beans!

    Gil shut it down before anyone asked about how this would effect pain patients. I guess he knew that was coming.


    I am so sorry you guys went through this (5.00 / 1) (#49)
    by Militarytracy on Wed Apr 20, 2011 at 07:32:45 AM EST
    Sounds too horrible to imagine.  One thing that I'm grateful for at this time as that it seems like they have dissolved visiting hours for children.  Most places seem to have something that converts to sleeping for parents too now even though some are very uncomfortable.  In the titanium rib program I am actually expected to be present with Josh at all times.  He is older though now, so if I want to run across the street to grab something to eat the nurses are fine looking after him for a bit.  He's good at pushing that button these days too :)

    Intense (none / 0) (#66)
    by andgarden on Wed Apr 20, 2011 at 07:12:54 PM EST
    I can tell that was a horrible experience. You have chronicled it expertly, though.

    That's horrifying (none / 0) (#44)
    by andgarden on Tue Apr 19, 2011 at 11:44:37 PM EST
    I'm sorry.

    Thanks andgarden (none / 0) (#48)
    by Militarytracy on Wed Apr 20, 2011 at 06:08:13 AM EST
    That has been my only experience with a facility trying out a program like that.  We went back to Memorial with Josh a year later for another procedure and they weren't implementing that program any longer.  The nurse that did his intake saw the look on my face when we discussed the program and reassured me that they were no longer trying to do anything like that, I got the impression that we were not alone in what we experienced and the hospital had done away with it.

    assurances that (none / 0) (#14)
    by JamesTX on Tue Apr 19, 2011 at 03:36:56 PM EST
    pain actually gets treated is always a minor aside in this strand of rhetoric. It is paid obligatory lip service while everything possible to prevent prescribing is implemented.

    Where's BigPharma When You Need Them ? (5.00 / 1) (#13)
    by ScottW714 on Tue Apr 19, 2011 at 03:33:15 PM EST
    In Texas, you have to show a drivers license and sign for OTC meds that contain the ingredient to make meth.

    So you go in sick as a dog, grab the stooopid cards they have in place of the meds, give it to the pharmacist along with your drivers license.  How many people are getting exposed to your illness through this process.  Everyone present, including the pharmacists, and anyone coming into contact with the pharmacist and/or the pen/clipboard, which if you have a certain class of prescription, you have to sign as well.  

    It's more important to stop drug abusers than to keep the rest of the population healthy.

    Which is what these crack-downs always amount to, good doctors who are doing nothing wrong, put in fear, and denying needing people their meds in order to catch the guys who are doing wrong.  

    And then it's all going to boil down to a judgment call about a field the decision maker knows nothing about, how could possibly fail ?

    When it comes to drugs, the people following the law are the ones that always bear the burden.

    Yes, same here (none / 0) (#35)
    by Zorba on Tue Apr 19, 2011 at 06:04:20 PM EST
    If I want some Sudafed (the only decongestant that works for me), I have to show ID and sign their paper.  This drives me up a wall.  Let's punish everyone, and make everyone feel like a criminal, because there are some people out there who may use it do make meth.  (And, slightly off topic, let's not even go into what we have to go through at the airport.  We're all guilty until proven innocent.)

    It should be noted by (5.00 / 2) (#16)
    by JamesTX on Tue Apr 19, 2011 at 03:51:12 PM EST
    medical marijuana activists that just because something gets designated as a legitimate medicine doesn't mean they are going to let many people have it. Even if medical marijuana proceeds, I fear what is happening with opioids is the next step.

    Opioids share a lot with marijuana. Both are natural plant substances which have been used for thousands of years by humans (the so called "semi-synthetic" "...oids" products -- oxycodone, hydrocodone, and others -- are usually simply various analogues of morphine which can be produced easily from thebaine. Thebaine is the major alkaloid extracted from the poppy -- morphine and codiene are minor components -- so this allows the pharm companies to make much more efficient use of the plant).

    Both have been demonized by organized political attacks which resulted in increasing criminalization over the last century. Both were demonized without any real scientific evidence. Both are too old to be patented. Did I mention both are too old to be patented? By the way, both are too old to be patented. Both are largely nontoxic in terms causing damage to the body (although it is possible to OD on opioids, it is less common than the stats make it appear).  Both have risks which are quantitatively not much different from many activities and products people engage every day with no legal restrictions.

    By the way, we are going to lose this battle.  The enemy is a confluence of corporate, medical, and law enforcement industries which have too much to lose. But the story must be told. Torture for profit is no different than torture for any other reason.

    And there you have it (5.00 / 3) (#18)
    by Zorba on Tue Apr 19, 2011 at 04:04:05 PM EST
    With anything that is potentially useful but not patentable, there's not a lot of money in it for Big Pharma.  Marijuana can be grown in your own home under grow lights, or in your back yard, for that matter.  Disclaimer: and BTW, I deny any direct knowledge of this whatsoever.  Ahem.  ;-)    

    It reminds me of that (5.00 / 0) (#23)
    by JamesTX on Tue Apr 19, 2011 at 04:18:11 PM EST
    line in Brave Heart -- "The English...they are many..."

    guess what word on the street is right now? (5.00 / 1) (#19)
    by Dadler on Tue Apr 19, 2011 at 04:06:39 PM EST
    stock up on pain pills and they will come.

    I can assure you of one thing, (5.00 / 2) (#25)
    by NYShooter on Tue Apr 19, 2011 at 04:32:09 PM EST
    The abuses by the authorities will be infinitely greater than those by the perceived "abusers."

    And this (none / 0) (#28)
    by Zorba on Tue Apr 19, 2011 at 04:40:32 PM EST
    has always been the case.

    Obama's "Jobs Program" (5.00 / 0) (#30)
    by NYShooter on Tue Apr 19, 2011 at 05:22:15 PM EST
    Since the "War on (illegal) Drugs" has been such a huge success they will now institutionalize it, build an even bigger bureaucracy around it, hire even more storm troopers, build even more prisons, and guarantee that millions of people who were once considered just your average citizen will now be re-classified as criminals justifying the lunacy that this program is sure to produce.

    I wonder if that wasn't the goal in the first place.

    Makes sense, yesterday's un/under employed, tomorrow's inmate.


    Hey, I guess (5.00 / 1) (#31)
    by Zorba on Tue Apr 19, 2011 at 05:37:25 PM EST
    jobs are jobs.  They sure haven't created many (if any) of the "green" jobs and "repairing our infrastructure" jobs that we were promised.  (I guess they went the way of the ponies and rainbows.)  More cops, more prisons, more support personnel for both.  Sure, there's your jobs for you.  Sad, isn't it?  (And it's not just the "War on Drugs" creating more prison-industrial complex jobs.  They need more people to track us with the continued wiretapping and the GPS's that they want to place on our vehicles without warrants.  Big Brother is happy as a clam.)

    With pols looking everywhere for budget cuts... (5.00 / 2) (#36)
    by Romberry on Tue Apr 19, 2011 at 07:36:08 PM EST
    ...I have a suggestion: Start the cuts with money slated to be wasted on this new plan.

    So... (5.00 / 2) (#39)
    by MileHi Hawkeye on Tue Apr 19, 2011 at 10:02:58 PM EST
    if one doesn't go to the same pharmacy every time they get their Rx filled, they're going to be branded a "doctor shopper" (not that isn't already happening)?  Wonderful.  Why not just tattoo them with a scarlet letter of some sort.  

    And seriously, what is going to stop these "pill mills" from setting up shop across the border in Mexico or Canada?  Where there is a will (or demand), there is a way (or a supply).  Humans are funny that way.

    Most people who are (none / 0) (#47)
    by JamesTX on Wed Apr 20, 2011 at 02:11:21 AM EST
    effected by this will not know it for for some time -- many may never. After they get tagged in the system, they will simply not be able to get any pain medicine anywhere. No explanation. No reason. Just no meds. Since you can't demand to see your medical records in most places, you'll never know it or know why. The doc's won;t tell you. They don't want to argue with you, and they aren't about to prescribe to you and risk getting investigated. The only way to find out would be to get a lawyer to hire a doctor to tell you what is in it. Then, one day, when you are laying in your bed screaming from the agony of broken bones or something, you'll figure it out -- it was that time you went to the wrong pharmacy or said the wrong thing to the pharmacist -- and you have never gotten any treatment since!

    It is a fact that most people are turned in by pharmacists. This is their revenge. They are frequently viewed as invisible, powerless and unimportant people. Most people think of the doctor as the powerful person in the transaction. Nowadays a pharmacist can radically change your life. Choose them carefully, always pay respect, and remember they are watching. They can end any possibility of pain treatment for you forever!


    jeebus (5.00 / 1) (#52)
    by sj on Wed Apr 20, 2011 at 10:10:52 AM EST
    Hidden No-Fly lists which means restricted movement, routine intrusive security screening, loss of worker protections, lower and lower income, loss of home, working until 70 and doomed to chronic pain.  

    Is that starting to feel like a yoke to anyone?


    I think people (none / 0) (#33)
    by lilburro on Tue Apr 19, 2011 at 05:45:47 PM EST
    should be able to get opioids.  The fact that people in Florida are getting disproportionately more than people in the rest of the country needs to be dealt with though.  Doctors in FL prescribe 5 times more Oxy pills than doctors in any other state in the nation.

    Some states have worse problems than others.  Perhaps this would be better dealt with on a state by state basis.

    I think doctors (none / 0) (#37)
    by the capstan on Tue Apr 19, 2011 at 08:17:51 PM EST
    and druggists both need to tell patients what they have been prescribed AND listen if the buyer says, "No, I don't want that kind of drug."  The opiates and such affect me badly--but then some idiot tries to assure me, "Oh, this won't bother you!"  I've learned to tear up the prescription or walk away from the pharmacist.  

    Yeah (none / 0) (#42)
    by lilburro on Tue Apr 19, 2011 at 11:15:54 PM EST
    there are a lot of approaches outside of the uber-surveillance model outlined above.  Some states have MAJOR problems with trafficking, others do not.  Many people need these medications.  What are you gonna do?  Many people have taken medications they're not prescribed, if only one pill - what about that?  There has to be a different way to do this than just follow everyone all the time.

    Proper disposal? (none / 0) (#38)
    by Militarytracy on Tue Apr 19, 2011 at 10:00:39 PM EST
    I paid for the stuff!  I asked Josh's doctor last time we were in San Antonio if he could use some of his old pain medication from six months earlier and the doctor said it would be fine as long as he had enough remaining...but the stuff hasn't expired.

    Getting ready to hear on CNN (none / 0) (#50)
    by Militarytracy on Wed Apr 20, 2011 at 07:49:19 AM EST
    why our prescription drug problems have worsened and become something that must be looked at now.

    Okay....enough (5.00 / 0) (#51)
    by Militarytracy on Wed Apr 20, 2011 at 08:15:26 AM EST
    The guy CNN had on wants different sorts of pain control...like mind pain control.  And I'm not knocking anyone who wants to try that, but it has a bit of a junk science ring to it.  All people are not built the same for pain tolerance.  It is extremely varied, and most women (but not all) genetically have much more endorphins to walk off pain than men do.  With this sort of genetic variance I'm not going to be inhumane to people who don't have my endorphin system.  The guy was very concerned about "pill mills" in Florida.  All I can say about that is that there are so many people out there...working poor....who have no insurance and literally no money to pay cash for quaility care, and they are just trying to make it through one more day.  If I had chronic pain and I was working poor a pill mill would probably be my only viable option.  Just walking in the door some place obviously being a part of the working poor seems to have an instant label of drug abuser pasted on it too.  I don't have money and I'm hurting and I need to keep making a living, it isn't rocket science for me.

    This guy finished up making his point by saying that both Michael Jackson and Heath Ledger died of perscription medication overdose.  If that is his best argument all I can say is SHAME ON YOU DUDE.  Heath Ledger could not sleep, he had insane insomnia and if you can't sleep it will destroy you.  He was trying to sleep.  Mother nature is not perfect....human beings are born with certain health challenges and some of them die earlier than the rest of us because of that. The loss of his life is horrible but life is not perfect and I'm not about to violate someone's every moment and their entire life in order to keep them alive and living according to my standards 24/7.  I have my own life to worry about and my own pain and health to manage thank you. As for Michael Jackson, his doctor administered what killed him.  Michael Jackson did not die because of a pill mill, he had his own doctor at his beck and call.  I fail to see how either one of these men's deaths has anything to do with this current cooked up "crisis".


    Re: (5.00 / 1) (#53)
    by lilburro on Wed Apr 20, 2011 at 10:18:02 AM EST
    The guy was very concerned about "pill mills" in Florida.  All I can say about that is that there are so many people out there...working poor....who have no insurance and literally no money to pay cash for quaility care, and they are just trying to make it through one more day.  If I had chronic pain and I was working poor a pill mill would probably be my only viable option.

    Time magazine has this anecdote

    Case in point: a man outside the Broward County clinic who says he makes the 11-hour drive from Tennessee every month just to get his medication. He says he is prescribed medicine for chronic neck pain stemming from a forklift injury but cannot get the medicine he needs anywhere near his home. He won't divulge what he is prescribed. "I'd rather not say, but it's helping me," he says. "I'm not a junkie." The medicine allows him to keep working as an excavator, he says. "They help people that can't get medication that they need," he says. "Thank God there are places like this." Though he agrees that some people take advantage of the clinics, efforts to shut them down are misguided, he says, and pain medication is essential. "It's everybody's constitutional right."

    Having to drive 11 hours to get your medication is just ridiculous.



    pill mills (5.00 / 1) (#54)
    by sj on Wed Apr 20, 2011 at 10:34:29 AM EST
    uh-huh.  Because that's one of the worst problems facing the populace today.

    Barry Bonds!  Pill mills!  While our society falls down around us.  


    Apparently, the scourges we must (5.00 / 2) (#56)
    by Anne on Wed Apr 20, 2011 at 11:10:49 AM EST
    devote our dwindling resources to are not things like jobs and foreclosure fraud and insufficient health care and poor child nutrition and affordability of higher education and the well-being of seniors, and what-not, but pills, porn, poker and planned parenthood - which, once "under control," will lead us to the promised land of prosperity and peace.

    I've had just about enough of these people.


    Well said Anne... (5.00 / 2) (#57)
    by kdog on Wed Apr 20, 2011 at 11:47:42 AM EST
    lets not forget our crumbling infrastructure...but who can worry about potholes, old bridges, and antiquated power and telecomm grids when somewhere somebody has a pharma-enhanced smile on their face, or a gamblers high outside of Wall St., or making love for fun.  

    These clowns don't wanna administrate a nation of free people, they wanna administrate a junior high school.


    There's a cynical part of me - a very (5.00 / 1) (#63)
    by Anne on Wed Apr 20, 2011 at 01:46:13 PM EST
    cynical part, I'm afraid - that finds it extremely small-minded and downright mean that more effort seems to be being put into taking away the few small pleasures people have to cope with a terrible economy than there is in actually doing something about the things that are squeezing people to death and pushing them over the edge.

    Where is the jobs program?  Where is the help for people who are being railroaded to foreclosure by services and lenders willing to falsify documents?  Where is the concern for the average person?

    It all just makes me sick and angry.


    Anne, Anne, Anne... (none / 0) (#64)
    by kdog on Wed Apr 20, 2011 at 02:48:56 PM EST
    the only power the government has is to crack down on criminals...when the real criminals are the government itself and their paymasters/country club cronies, that leaves criminal creation amongst the proles as their only alternative to keep the meat grinder in flesh.

    Jobs...unless the job involves handcuffs or M-16's or deportations or auditing broked*cks, they ain't creating any.


    If they wanted to crack down on (none / 0) (#65)
    by Anne on Wed Apr 20, 2011 at 03:07:02 PM EST
    criminals who are really costing society and the economy, they need look no further than Wall Street and the banksters; that they are pretty much turning a blind eye to that kind of crime tells me they are benefiting too much from it to put it at risk.

    I'm convinced that if the government could make money on poker, porn and pills, they'd be going out of their way to hook people up.  And when they are getting a piece of the action, that's exactly what the states do: advertise the crap out of it to bring people in to gamble away the same money they say they are protecting the people from gambling away when they want to do it online.

    How else to explain the legalization of slots and table games in more and more states; it's the  state getting a piece of the action they don't get from online gambling.  Are the MegaMillions and PowerBall not "gambling?"  Of course they are - but the states are being cut in on it, so that kind of gambling is okay-dokey.

    Do they think we don't understand how this works?



    with all the lawyers on this site (none / 0) (#67)
    by NYShooter on Wed Apr 20, 2011 at 09:10:10 PM EST
    I can't get an answer to the question I've asked numerous times.

    How come, with so many legal experts and economists stating flat out that fraud, and other crimes, were committed in the financial debacle no criminal referrals have been issued. Elliot Spitzer, (please, no wise cracks) who certainly knows something about Wall street malfeasance, is apoplectic with anger over this administrations failure to carry out it's responsibility.  But, my question is, is it even legal for the top law enforcement officials of the Land to simply refuse to  investigate such widespread, heinous, and damaging, crimes?

    He's calling for Holder's resignation, not that it will do any good. He says that if, for whatever reason, he won't carry out his sworn duty, he sdhould resign. I couldn't agree more.


    There is a large (5.00 / 0) (#59)
    by JamesTX on Wed Apr 20, 2011 at 01:00:54 PM EST
    population of people who travel for pain treatment. It is so hard to find. But it looks like a major emphasis of this program is going to be to stop that. It looks like they intend to flag people who travel unusual distances and get controlled substances. Of course, the database technology can now do that very effectively, so they will do it. That means if you drive too far for pain treatment, you will be tagged. They will then bust your doctor, shut them down, and you will be flagged on the system for no more pain meds.

    I wanted to think this (none / 0) (#55)
    by Militarytracy on Wed Apr 20, 2011 at 10:40:48 AM EST
    ramp up was somehow warranted but I'm not seeing it.  What I feel like I am seeing is a lot of people headed for some big pain. Plain old aspirin works well for me, and tylenol doesn't seem to work much at all.   Naproxin is wonderful FOR ME while Tylox is not that great if I'm in real pain.  My understanding of how all that works is that if something blocks the prostaglandins for me really well, my own body kicks out some great endorphins to cover the rest.  I've had an amazing pain tolerance though my whole life.  My husband and son obiviously do not though.  In order for them to experience real relief when they are in serious pain they need something to bind to the opioid receptors because they don't have my endorphin creating abiities.

    As always, the alternative (5.00 / 2) (#58)
    by JamesTX on Wed Apr 20, 2011 at 12:52:37 PM EST
    treatments will continue to be proposed and researched. Meditation and mind control are part of any pain control strategy, but there is a big gap that they don't mention when promoting these programs as replacements for pain medication. Anyone feels less pain and more comfort when they are able to relax and meditate. But that is not the reality of the person in chronic pain. It is hard to meditate and do deep relaxation in most employment contexts. The benefits of pain meds follow people into their employment context and allow them to function. Next time you are on the spot with your work and your boss, try telling them you need to relax and meditate. Right.

    Michael and Heath show up frequently in these presentations. Their photos have promotional value, and people "know" them. Now the government is using these crying mothers and father. I even shed a tear last night when watching the press conference. This is powerful persuasion which really is prejudicial and doesn't represent the larger picture. The dead giveaway that their case is weak is that they need to employ anecdotal and case evidence at all.  When it comes down to the actual statistics, they are creaming heavily (scooping the best data to support their view which is often based on bad design). In the data they make use of, many people and data points in the categories don't really fit in the qualitative description of the category, but inflate the statistics they are looking for. For instance, the idea that "non-medical users" includes ANY ONE instance of use of another person's medication -- ever. Of course, we all know that is good enough for the prosecutors, but does someone who took one of their brother's pain pills two years ago really qualify as a "non-medical" user or "abuser"? You decide.


    I think alternative methods (5.00 / 2) (#61)
    by Militarytracy on Wed Apr 20, 2011 at 01:35:39 PM EST
    may work for some people, and NOT AT ALL for others.

    prison complex job program (none / 0) (#60)
    by jedimom on Wed Apr 20, 2011 at 01:01:07 PM EST
    this is the only 'jobs' program O has implemented ironically. At least a successful, well funded one. At peoples expense, of course.

    Let's grow the economy and leave adults alone.

    As more states pass MMJ, I note the DEA is eager to expand RX ABUSE!! stories and enforcement.

    If there was more MJ available, peeps would need less RX for pain.

    First, it is very (5.00 / 1) (#62)
    by JamesTX on Wed Apr 20, 2011 at 01:36:18 PM EST
    important too realize the MMJ is not a substitute for opioids in pain treatment. Opioids are what keeps you from screaming bloody muder when your bones are broken or they have cut your body open in surgery. Try smoking a doobie for that. Many people seriously need these meds. Although MMJ should be available, it should not be promoted as a solution to this problem, and especially, one should never use opioids to promote MMJ by saying that at least MMJ is not as "bad" as opioids.

    I think one reason Obama turned on us here has less to do with his cruelty as political expediency. Now that his health plan will bear significant public cost, he must find ways to reduce utilization. The message seems to be that they don't want people utilizing the system for pain treatment. That makes sense. If the docs can't "fix" you, then you are on your own. That may be an economic reality, but they need to let up on the controlled substances so that people will have other alternatives after the medical system gives up on them.


    None of this is new (none / 0) (#68)
    by SeeEmDee on Thu Apr 21, 2011 at 08:20:29 AM EST
    Everything is cyclic. Round and round and round.

    When the first Fed drug laws were passed, doctors were an easy, 'low-hanging fruit' target, then as now.

    When you can't do a damn thing about illegal drugs, you whup up on the doctors, as they're sitting ducks. Just to make yourselves look good. So obvious...