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Ohio's rogue prescription crisis


Below is a column by Ohio Attorney General Mike DeWine that was printed by the (Cleveland) Plain Dealer's opinion editorial page on March 8, 2011.

Ohio's families and communities are under siege by the misuse and abuse of prescription drugs.

A recent execution-style double homicide in Ashtabula County is the latest link in a disturbing chain of prescription drug-fueled crimes. The Ashtabula County sheriff said that the trafficking of OxyContin and Percocet -- the two most popular prescription drugs in his jurisdiction -- was "running wild."

Ashtabula County is not alone:

  • In Scioto County, the health commissioner declared a public health emergency.
  • In Jackson County, an OxyContin addict strangled to death a 72-year-old woman in a murder-for-hire plot and then spent the $50,000 payoff on more OxyContin.
  • In Gallia County, 19 out of 38 people indicted over a period of one month last summer were charged with possession of or trafficking in prescription pills.

What's driving the demand for -- and the abuse of -- prescription drugs?

Most doctors who prescribe medication to alleviate pain have only their patients' best interests at heart. However, some patients "doctor-shop" in an attempt to score multiple prescriptions for painkillers.

In addition, a number of rogue clinics or "pill mills" prescribe and dispense prescription drugs inappropriately. For example, in Scioto County -- with only 76,000 residents -- at least eight pill mills pump out approximately 35 million oxycodone and hydrocodone pills per year -- an average of 460 pills per resident.

The street value of these drugs is about $1 per milligram, so an 80-milligram tablet sells for about $80. It's easy to see how the lure of quick cash can be just as addictive as the drugs.

The consequences of prescription drug abuse affect every corner of Ohio:

  • In 2007, unintentional drug poisoning surpassed motor-vehicle crashes and suicide for the first time as the leading cause of injury death in Ohio. According to preliminary data from the Ohio Department of Health, an average of four Ohioans a day -- at least 1,373 -- died in 2009 of overdoses. Those deaths were from both prescription drug and other drug overdoses.
  • In Central Ohio, babies born to mothers who abused prescription drugs spend time in neonatology to "step-down" from their addiction to painkillers -- a process that takes anywhere from a few days to a few months, and the long-term effects remain to be seen.
  • In Adams County, four children were orphaned when their mother overdosed in May 2008, and their father then overdosed the following April.
  • In Montgomery County, an 11-year-old girl died in 2009 of a morphine and OxyContin overdose.

The cost doesn't end with the shattered lives of individuals or the resources spent by law enforcement. According to a study recently published in The American Journal of Emergency Medicine, during 2007, almost 700,000 Americans visited emergency departments for drug-related poisoning. The total cost came close to $1.4 billion, of which Medicare and Medicaid picked up approximately 41 percent.

Prescription drug abuse and trafficking in Ohio is clearly a crisis -- an epidemic that is bigger than one person or even one office can combat. Battling it will take a concerted and coordinated effort.

My office is dedicating significant financial resources to the fight. I recently tapped Adams County Prosecutor Aaron Haslam to spearhead that effort. We plan to hire two assistant attorneys general to work with local law enforcement and county prosecutors to support them in preparing and prosecuting prescription drug cases. And, through my office, we'll also use the Ohio Organized Crime Investigations Commission to pursue those who illegally distribute prescription drugs.

I commend Gov. John Kasich, who recently announced a range of new resources to combat the problem, including funds for a Scioto County drug treatment center and access to advanced treatment methods. Kasich also appointed former Ohio Attorney General Betty Montgomery to advise a new prescription drug addiction task force, which will work with state agencies, the Ohio Supreme Court, local law enforcement leaders and other states. And an interagency group will coordinate the efforts of participants from all major areas involved in the treatment, law enforcement and judicial systems.

State government cannot, however, fight this battle alone. The private sector can reinforce the front lines through prevention and education initiatives.

Organizations like the Ohio State Medical Board must aggressively question the continued licensing of physicians who obviously violate their oath to "do no harm." Most of the doctors the board has taken action against in recent years were first sanctioned by another agency. If the board would step up, be the first to police its members, and stop waiting for others to take action, it would start becoming part of the solution.