Monday, November 19, 2012

New Frontier of the Drugwar: Prescription Drugs

Borderland Beat
 
 
Notes:
It may surprise some to hear that 1 of 5 teens have used Oxycontin recreationally. It probably will surprise most to know that is a 2007 statistic, and prescription drug use has taken a 40% increase among teens. Oxycontin is heroin made in a lab. Its creation targeted usage was  late stage terminal cancer patients. However, soon physicians were prescribing the drug for post op pain, then for pain derived from any source.  Overdoses for prescription drugs is more than heroin and cocaine combined. 
The US recreational drug of choice remains by far marijuana.  Opiates, those grown from the poppy flower is still among the lowest use in the world.  That includes heroin and cocaine.  There is a tiny rise of heroin use of 5%, however 5% increase of low numbers will still be low number.  It is an issue to watch however as heroin is a cheap substitute  for chemical heroin, Oxycontin another is Krokodil.  That may be a main contributing factor.    Oxycotin is one of the drugs in the chemical opiates a separate calculation.  RX drugs for non medical useage is the highest drug use second to only marijuana.
Prescription narcotics includes codeine, morphine and oxycodone.  The U.S. has only about 5 percent of the world's population but uses about 80 percent of all the RX opioid drugs.  I use several resources to garner stats, one is ….Paz, Chivis
Heroin Use
Below is a repost of forum poster "DD" -click on any image to enlarge-

Should prescription drug abuse be treated primarily as a medical or a criminal justice matter? At the Texas Senate Criminal Justice Committee last week, the answer to that question seemed nearly a faint accompli, with the focus more on tactics and best practices for maximizing prosecutions of doctors and potentially patients. See the Texas Tribune's coverage.
Americans consume 80% of the world's opiates, including 99% of the world's hydrocodone, Dr. Emilie Becker of the Texas Department of State Health Services told the Texas Senate Criminal Justice Committee last week. (Here's the agenda and here's the link to the online video.)
In 1990, said Becker, the Center for Disease Control estimated there were  575,000 new opioid users nationally; by 2010 that number had mushroomed to 4.5 million, with the number of drug-related deaths rising with use.
She presented this striking chart to the committee, demonstrating that last year, for the first time, drug overdoses eclipsed deaths from firearms and traffic accidents:
Becker said the rise in prescription drug use increased in lockstep with number of people who die from them, but the demographic of people dying of overdoses is changing: It's more likely white, male and middle aged.
She cited Austin in particular for a 41% increase in overdose deaths, which she mostly attributed to prescription drugs as opposed to heroin or other illegal drugs. Becker ominously called the "pen" a "deadly instrument in the doctor's office."
One in five Texas teenagers have experimented recreationally with prescription drugs, said Becker. By far the biggest proportion of opiod use among teens was attributed to kids drinking codeine cough syrup.
The volume of prescription drugs presently on the market is vast. Sitting unused in US medicine cabinets, she said, is "enough hydrocodone to medicate every American adult 5 mg every 4 hours for 1 month "
Becker's primary suggestions involved better coordination between state regulators and law enforcement, and she agreed with other speakers that the Legislature had so recently passed new enhancements on these topics that one couldn't yet judge the impact of changing the law or what additional changes might be beneficial.
But she emphasized that she wanted to target not just doctors at "pill mills" but also physicians who prescribed the pills (presumably in good faith) as part of their regular practice. That seems to step pretty quickly into dicey territory, especially for Republicans who spent the last two years bashing government interfering with the doctor-patient relationship or dictating medical care to physicians.
 DPS Col. Steve McCraw continued with the tough talk, declaring, "A pusher is a pusher, a drug trafficker is a drug trafficker whether they've got a lab coat or what." However, he agreed the new laws haven't yet had tie to be fully evaluated and recommended staying the course, though at Sen. Huffman's insistence he said that if the Legislature chose to prioritize this task, it could pony up for more investigators at the agency to target doctors.
Judge Ryan Patrick, son of committee member Sen. Dan Patrick, was appointed by Gov. Rick Perry as a Houston-area district judge, but before that he was prosecuting prescription drug cases. He praised DPS for retraining narcotics investigators to monitor the state's prescription tracking program for doctor shoppers. Thanks to that shift in resources, the Harris DA saw a doubling of cases filed, all with "incredibly high" clearance rates. Most of them focused on people who go to 30-40 doctors and/or pharmacies per month, he said. "The evidence on these cases was terrific."
Multi-agency task forces went after pill mill clinics, said Patrick, but the clinics are getting smart. Some require blood draws, he said, because they know undercover police officers can't get stuck with a needle. Frequently, they're charging higher entrance fees. He said a special exception for nurse practitioners operating clinics created particular headaches.
Prosecuting pharmacists remains difficult, he said. It requires the DA's office dealing with the administrative boards, which they'd never done before, and administrative regulators to cooperate with law enforcement more than they're used to. It's easier in some instances to prosecute patients. Under the recently enhanced statute, he said, a patient commits a felony if they go to a new doctor for a prescription and don't notify their old one. 
According to the state pharmacy board, over one million dosage units were reported pilfered in 2010, declining nearly 50% in 2011. A Houston PD rep testified that recent changes in the law have been effective and suggested no changes to penalty structures, though he recommended more data gathering. Before regulation and recent penalty enhancements, he said, pain clinics would pop up around Houston "like mushrooms after a Texas rainstorm."
TCJC's Travis Leet said that already 30% of incoming prison inmates are incarcerated for drugs, 75% of those for low-level possession. He encouraged alternatives to the criminal justice system, particularly for users, noting that returning veterans numbered disproportionately among those addicted to pain killers and other prescription drugs. (See his written testimony.)
Another doctor urged the committee not to interfere with the doctor-patient relationship and that there were still many people out there with "untreated pain." Sen. Huffman insisted that wasn't the intent of the committee, they just wanted to keep such drugs "out of the hands of teenagers, basically" she said. (One notices that doesn't quite get to the white, male, middle aged demographic described by the DSHS as the main prescription drug abusers.)
 Finally, Jeannette Moll from the Texas Public Policy Foundation said that this is a different type of crime because most purchasers didn't purchase the drugs illicitly. She called for a statutory presumption that offenders convicted of possession be sentenced to treatment instead of prison.
The presumption would not apply to trafficking crimes nor where the judge thinks the defendant poses a danger to society, she suggested. She also advocated a "Good Samaritan" exception be crafted to prescription drug statutes to encourage people to call 911 in response to an overdose.
 
Read UN Drug report 2012 
 

28 comments:

  1. Thanks for letting the truth come out. Houston is now the hub for all rx drugs. It's out of control. Check out google Winrock Clinic, Houston raided last year. They were selling rx's for oxys.for 3 years inculding a 16 year old girl who was going to have a baby in 3 months. It's sickening. I was tod that thr customers would drive for 15 hours to go there. With over 199+ mills in Houston things need to change. My efforts to get changes made is like talking to the wall re: DEA. THE TEXAS MEDICAL BOARD DOES MORE,but still not enough. What a f'd up mess. Keep us informed cause we hear nada here in Houston.

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  2. The legal recreational drug alcohol sucks, in many ways. One thing this proves though is that the government can allow its sale without condoning, but it also points out that the government understands that people want to alter their state of mind. Those who made access to alcohol a constitutional right, were careful to make it alcohol and alcohol only, and that was their mistake. At the time the U.S. was a deeply racist country, and that was their primary motivation, but that same racism lingers today.

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  3. and this is just a new finding? this has been known for years, its way easier to get pills than it is to get street drugs even, and street drugs are way easy to get.

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    1. 4:24. Hope you're being sarcastic. Many don't know about this. I counsel "Clueless parents" daily, who when their kid od's they had lnow idea!! Denial is a f'd up place to live. Maybe we should educate our neighbor's cause everyone knows someone on pills these days. How about alittle empathy for the children??? The average age of those I treat is 12 years old. Babies still. All got their parents meds. Beyond f***ed.

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  4. The first priority is that the drug companies sell mega dope. The death rates figure into an appearance problem politically. The pharmacy committees facilitate drug sales. Do you think I'm being cynical? Google articles concerning foster children on psych drugs in Texas. Its a laugh them talking about the difficulty of prosecution and notice its the pharmacist being considered for such. A lab is making synthetic heroin and selling it. For the most part our drug problem is about where is been charted to be except they must sell, more, more, more.

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    1. 4:54. I agree with your statement on the crime perpetrated on our kids on psch.meds. It is horrific. May I add that we have to do more for our kids dying on prescription drugs. The average at risk kid I treat is 12 years old. Where did they get the drugs? Their parents medicine cabinet! When I call the parents they are in complete denial. It's crazy at best. How about we in the US take a second to educate a neighbor? As for the dealers who divert drugs, 25 hard years in prison! To the murdering LEGAL DRUG PUSHING DR.S AND PHARMACISTS, the DEA is finally taking their licenses,assets and if they killed someone, murder charges. Check the DEA site, Dr.s in trouble or your state medical board. There are many things we can do to save our kids, including calling CPS if their parents are wacked out on drugs. My prayers go out to all the chidren in every country, the innocents who get caught up by a society that is greedy and more concerned with their own selfish needs. Thanks Chivas. Great job!!!!!

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  5. @ 4:24PM

    well yes it is news, to many people. Though I have known about the issue for years, I would not be so self absorbed to declare, "I know this, and that is enough".

    But the figures, and stats are the latest only 2-6 months old depending on the source.

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  6. The problem in Massachusetts exploded when it offered universal healthcare. People could get drugs for much less than what they were worth so patients would doctor shop to get their hands on as many pain killers as possible. They then sell a bunch and keep a few for themselves. They actually turn a profit off their low income health insurance plan.

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  7. Codeine cough syrups and rxs drugs have been abused for generations. This isnt a new problem.

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    1. 7:24.Are you joking??? There has never been a time in the US where this many people were addicted to prescription drigs, including the 70's. Pr thid many people overdosing and or dying from them. The stats are available, please read the before making such a ridiculous comment. It insults BB and every professional who works trying to save lives. Your nonchalant additude is one of the many problems we face. Read a book now and them.

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  8. Chivis, do a little more research on Krokodil, especially on YouTube. In the old Soviet blocks, the Afghans have flooded the towns and cities with heroin as a type of revenge or the war. Towns are o poor that they have be to Krokodil. It's kinda like how meth and coke are related. From what I have read, it's a mixture of eye medication and an opiate that dries you out, literally. Your organs will dry and turn to plastic on the inside and your limbs will fall off as if you have leperisy. Disturbing.

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  9. most of the "pill mills" go under the heading of, pain management clinics. and as far as the stats and figures, being that it was an election year, an old german saying goes something like, don't believe any statistics that you, yourself have not doctored. most of these deaths arent from the purity rate fluctuating like it usually does with street drugs, its more akin to some kids trying to one up each other, or, experimenting with their dogs medicine for depression..

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  10. This is where the "let's legalize all drugs" argument should stop. Our country would face a drug epidemic of huge proportions nothing like what we have right now. People don't do drugs because they are a forbidden fruit, they do them for the effect and when they least suspect it they are addicted and everthing goes downhill from there. I know a person who injects a large amount of oxy every day, she got fired from her job a year ago and steals from her family to get her next score. It's sad.

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  11. oxcy cant be seen as a medical issue..its a criminal issue cause they still charge you with a Felony if u get caught with a pain killer and arent prescribed to you..

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  12. oxcy cant be seen as a medical issue..its a criminal issue cause they still charge you with a Felony if u get caught with a pain killer and arent prescribed to you..

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  13. My pain doctor in Texas felt the long arm of the law breathing down his neck. I got sick of random drug test and decided to seek alternatives. Last week received a letter that he is closing his practice. Probably more BS from Obamacare than the DEA but I see this as a trend in medicine.

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  14. Chivas. Hope you are doing better today. I read the UN drug report also due to my job with at risk teens. I applaud you for taking the time to tell those who think WE IN THE US ARE LIVING THE GOOD LIFE. Plus, it's damn hard to get facts here. I finally found out that 43 Dr.s surrendered their licences after the raids in Houston early last month. I can't fathom the effort ot takes fot BB to bring all this to us.Without true insight, how the hell are we going to let parents know, they are part of the problem! It breaks my heart to read about all innocents in both or countries dying. Stay strong Chivas and screw the "KNOW IT ALLS." Your friend in Texas.

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  15. Thank you Chivis for putting this on the "big screen" where many more people will see it.

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  16. krokodil is not made from heroin, it is made from codiene/ eye drops?? i wonder who thought of that one, maybe someone was thinking since eye drops have saline in it, it would be more healthier than the water in those places, many places in siberia can get krazy dirty, but it is true that the many of the ones who traffick the afgan heroin are doing it to poison the youth of the west, im sure the reasons fluctuate with making a profit from H, its almost like mexico in the way that you will see slums with people in squalor, then you will see a huge gawdy mansion right next door to a hovel

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  17. I read bb daily I read this story the day it came out andd unfortunately was to late to help one of my bestfriends who pass away yesterday from one of these so called oxycotin I had no idea he was even taking them he was a real good guy and my heart goes out to his poor mother he was not a junkie we had no way of telling he was taking them till it was to late its still a shock to me that I lost him to a pill that I had just read about

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  18. Maybe now the War on drugs can come home to roost as the U.S. Crackhead will just migrate to sniffing gas if you take all their meds away

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  19. 4:09

    I relate to your loss which will be self explanatory when you read a post I am posting tonight or in the AM.

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  20. I'm in FL, 45min south of tampa, and the problem is huge. Huge is an understatement. You used to see out of state plates when the weather got cold up north, now you see them year round. Anyone with $400 to invest in a MRI, then a doc visit, can get blues (as what we call the 30mg pills) ,bars (xanax), an morphine. Usual first visit for a new patient (with absolutely no prescription history, and nothing wrong with thier back) gets 180 blues, 90bars(2mg), an 90 30mg morphine tablets. The "blues" go for $25 a peice, cheaper in bulk, bars are $5, an morphine is $10. It's literally made a new class of drug dealers, mostly white kids from the suburbs. The profit margin is huge! The problem is worse. We have pill mills everywhere. Everyone and thier mother are on them. It's in all walks of life. I sold them (yep, made a living off my friends dieing, im proud.) to all kinds- doctors, lawyers, nurses, cops, everyone. Once you take them for a few days straight, youre done. Something needs to be done, but what? What they're doing now with the pharmacys and doctors are making it insanely hard for people with REAL pain to get/fill thier meds. There is no good option for this problem. Someones going to get screwed.

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  21. Dan. What a contradiction, first you say you are proud of selling drugs, then you're worried about peope getting meds.for real pain. My question to you is what psych drugs were you prescribed and aren't taking??? You need help badly....you are a danger to anyone you come near. Please get it soon before you or someone else is killed.

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  22. @7:17 So you didn't pick up on my subtle sarcasm? It's ok, the Internet is a tough place to understand sometimes. Why on earth would I be proud of being a contributing factor of my peers dieing? Now, maybe I didn't realize what kinds of consequences my actions had, and maybe, just maybe, I woke up after a string of close friends died from OD's. Maybe, just maybe, I myself have a legit prescription for pain killers that I was having trouble getting filled because of what is going on. Maybe, just maybe those were the things that I started to focus on, instead of making a profit at others expense and thinking "oh well, they're gonna get it from someone, I might as well be the one making the money." But that couldn't be it, right? Nah, I think I like your version better. You know, jumping to conclusions, questioning the sanity of others, and then saying that people are threats to society. If I'm a threat to anyone, then you must be a threat to procreation. Re-read what I wrote, see if you can't see that oh-so-subtle sarcasm.

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  23. Chivis, I would like to add the other side of the story that you neglected to tell for this peice, though I will say you almost always give fair and balanced coverage.
    The other side.....
    I am a 50 year old paraplegic and have been a spinal cord injury-Incomplete-meaning I still have feeling below my level of injury)for 28+ years. I was involved initially in a motorcycle accident where I had a head on collision with a car doing a u-turn on top of a hill. I was thrown 120 feet in the air landed on my headed and was stopped when my back T-6 through T-12 were crushed when I impacted a telephone poll with my body. My injuries ranged from the spinal trauma to a severe head injury (TBI)to having my left leg pulled from the hip socket and the leg below my knee had all the skin and parts of my bone ripped off. Needless to say it was a miracle I survived and from that day forward I am in tremendous pain every day. Pain that would bring most people to their knees, yet I have managed to achieve a bachelor's and master's degrees and work as a guidance counselor and have done so for the past 19 years. I take pain medication to get through sleepless nights, deal with migraines, and the pain of being an active paraplegic particularly in my lower back.
    Over the last 28 years I cannot tell you how many times I have gone to ER's (30-40 times at the very least). On almost all of those occasions I have been accused of being a drug addict seeking a "fix" and thoroughly humiliated and chastised in these ER's. Not only am I not a drug addict but I have been bestowed many awards for my guidance programs, teaching activities, and community involvement.
    One anecdote that might illustrate best what I am saying is several years ago I fell from the upper bunk in a fifth wheel RV. Two days after intense pain at work (how many of you would go to work with the injury I describe below) I went to a ER in Mesquite Texas where my blood pressure was 210 over 167. The dr and nurse both came in and told me there is nothing wrong with you and we are not goint to admit you because there is nothing wrong with you. We believe you are looking for a fix and it would be insurance fraud if we admitted you. Needless to say I went beserk because after the length of time I have spent as a para I know my body and know when something is wrong below my level of injury--BECAUSE I CAN FEEL IT!
    I was not allowed to be admitted to that hospital. So I went to a spinal cord specialist at UT Southwestern in Dallas, where after a quick MRI, which the previous hospital also said they performed, and they located four serious new fractures in the fused together vertabrae in my back--as a matter of record UT Southwestern now uses my case study to teach their future spinal cord injury specialist.
    So before you go writing an article that basically states that all persons seeking and using oxycontin and other legal useful pain medications are simply drug addicts and dealers why don't you give my side of the story......maybe because it wouldn't sell as many papers, or get as many website hits, as a conspiracy theory article that focuses on the panic related to a few bad apples who choose to do wrong......on both the doctor and patient side. Do you have the guts to do that?

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  24. Chivas,
    One thing I forgot to add. Most doctors these days are incredibly releuctant to prescribe pain medications, even to those who need them and NOT TO GET HIGH BUT TO JUST FUNCTION AND GET RELIEF. If you have the balls cover my side of the story and don't make those of us who really need this type of medication out to be drug addicts.
    I transfered from my job in Dallas to one in West Texas and have yet to find a Dr. out here who will take me on as a new patient because they are afraid to take on new pain patients because of the outstanding (read a heavily sarcastic tone here) work of the DEA to come down on all doctors prescribing these drugs and not just the rogue pill mills.

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  25. Dear Doug

    You are the patient that should be given pain meds if that is the only relief, absolutely. I remember my spinal cord injury pain, an it is unlike most other pain, as it is in the forefront of your mind-always.

    Some doctors are pompous bastards. When I was in pain back then and I would travel my doc gave me a file and a letter with an overview of my history in case I would get jammed up, like a long flight you know how that goes, and had to get help. I used it a half dozen times over 10 years and doctors totally accepted it.

    Do you know what an IPG Implant is? I was one of the guinea pigs for the FDA. I had it in for 3 years which allowed me to exerxice nd build up the "good" muscles and nerves and down to very few pain mneds, in fact I took a low strength darvocet but not regularly. I then had another surgery, my fifth, and was as normal as a person can be that broke their back in two places. I have no pain day to day.

    If I had stayed on the meds I would not be as I am today. but some people have no alternative. You can file a complaint with the state and federal agencies against a doctor that refuses medical treatment to you, eg not accepting you as a patient.

    Just a thought, does Tx have medical MJ?
    good luck to you...paz, chivis

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