MIAMI - A new national strategy being unveiled Tuesday by the White House drug czar to combat prescription drug abuse aims to cut misuse of powerful painkillers like oxycodone by 15 percent within five years through education, stepped-up law enforcement and pill-tracking databases.
The effort will target pill mills that are dispensing thousands of painkillers, a growing drug abuse epidemic centered in Florida.
Under one part of the plan, more than 1 million doctors would be required to undergo training on proper prescription practices as a condition for their ability to prescribe the highly addictive drugs known as opioids.
"The key is that everyone realizes there is no magic answer to this," Gil Kerlikowske, President Barack Obama's national drug policy director, said in an interview with The Associated Press. "It's a really complex problem."
The first-ever comprehensive federal plan focuses on four main areas: education for prescribing physicians and the public, including a media campaign about the drugs' dangers; pushing for tracking databases in all 50 states; better methods of throwing out unused or expired prescriptions; and more intense training and focus by law enforcement on illegal pill mill clinics.
Florida is the epicenter of the deadly rise in abuse of oxycodone and similar addictive painkillers, with doctors in the Sunshine State prescribing far more of the drugs than all other states combined, according to the Drug Enforcement Administration. And Florida's pill mills are the supplier of choice for much of the eastern U.S., causing a ripple effect of drug overdoses and addiction to the north - a phenomenon dubbed the "OxyContin Express."
A recent report by Florida medical examiners found that in the first six months of 2010 - the most recent data available - 1,268 deaths in the state were caused by prescription drugs, or about seven fatalities a day during that span. Kentucky's governor says 82 people die of overdoses each month in his state.
Renee Doyle, a Fort Lauderdale mother whose son Blayne was in an oxycodone haze when he was struck and killed by a car in 2009, said he was able to get 240 pills on each monthly visit to a local pain clinic by doing little more than asking for them. More than 850 pain clinics are currently registered in Florida, where doctors prescribe 85 percent of all such pills in the nation.
"I think people were just not paying attention and then greed took over," she said. "They are legal drug dealers and they should be outlawed."
Although the DEA and local police recently arrested more than 20 people, including five doctors, in a crackdown on South Florida pill mills, Kerlikowske said it's not strictly a law enforcement issue.
"It's a real collaboration. It's not just a prosecutor and DEA. It isn't just the medical profession. It's everybody," he said.
Each part of the strategy has several goals. For example, on physician education, the plan calls for Congress to enact a law requiring a certain amount of training on responsible prescription practices of the most-abused drugs for medical practitioners who seek DEA registration to prescribe certain controlled substances. The Food and Drug Administration proposal would be the largest of its kind.
"There has been a flood of new medicines and many of the physicians out there weren't trained in using them, so there's a big gap in understanding how to manage these drugs," said Dr. Janet Woodcock, who directs the agency's Center for Drug Evaluation and Research.
Another piece would be a national education campaign featuring ads like the famous frying-egg "this is your brain on drugs" ad used in past antidrug efforts. Key to that is making sure parents keep prescription drugs out of the hands of their children, who are now abusing them more than any illegal drug except marijuana.
At the state level, the plan envisions prescription drug monitoring programs in all 50 states. Currently, 35 have such programs up and running, and they are authorized but not yet operational in eight more states, including Florida. The databases can help detect abuses and illegal diversion of pills by tracking physicians' prescriptions and how much pharmacies are dispensing.
The plan also calls for continued aggressive law enforcement efforts and better training. In Florida, Miami DEA chief Mark R. Trouville said he expects a number of physicians to be indicted based on a recent undercover probe involving 340 undercover pill purchases.
"We're trying to make a statement that if you think you're sliding by in a gray area, you're not, and we're coming," Trouville said.