Quit Looking Away

Last week, the Wall Street Journal and others reported on the skirmish in the Kentucky legislature around the rights of privacy and helping law enforcement shut down “pill factories” so common in different parts of our country.  I know that your first thought, because it was mine, is that this is a problem in the south just like we often think about other drugs, like crack cocaine and heroin, being just a problem in the big cities.  Not true.  This is a national issue that impacts everyone.

I am sure there was a lot of talk and discussion in Kentucky about whether law enforcement or physicians should be allowed to see prescribing data or if that was a violation of physician rights.  Of course, there is very little concern about bending the rules to find terrorists who potentially could hurt our country but to find physicians abusing their oath and killing our children, this is another story.  Perhaps these “physicians” ought to be viewed for what they are, drug pushers terrorizing our country for their own financial gain.  Take a look at this piece written last year for a clearer look at what is happening.

Pharmaceutical companies need to be a major part of the solution.  PhRMA has already done a lot of work in this area (http://www.phrma.org/issues/prescription-drug-abuse) and recognition is a necessary first step in the process.  They point out that 7 million people over 12 years old reported they abused prescription drugs in the prior month for non-medical reasons.  This is the number that admitted it and this is just a one month snapshot.  PhRMA also points out that only 9% of this abuse is with branded products and solutions must come from the generic part of the industry as well.  Dig into the data and it will really make your head spin.  Look at how many kids abuse OxyContin and Vicodin.  This is sickening.

Well, what could our industry do about this issue?  First, the industry clearly knows where the problem exists.  Unlike drugs like crack and heroin, prescription drugs are much more closely tracked through the system.  Physicians prescribe these drugs and pharmacists fill the prescriptions.  The industry tracks this just as we track everything else.  Physicians, pharmacists, drug reps and many others know exactly where the problems are in every community.  We track even the tiniest prescribing habit of every physician and I am sure we could identify the outliers who are abusing prescription drugs.

New product development work that stops potential abuse is a good first step, but obviously it is not enough.  Working with regulators to move behind the counter OTC products that can be abused is another step, but that may just make it a little more difficult.  How about really controlling the sale of these drugs through a system where there is a national register open to law enforcement and photos are taken when prescriptions are filled.  Special distribution systems, like we see for certain products with REMS requirements, may help.  Limiting the size of a prescription may help.  Work needs to be done to stop unnecessary prescribing of pain drugs after routine dental and other surgeries.  Why give 5-7 days of narcotics “just in case” the pain gets too much?  One-day-only prescriptions could be written that could be extended if needed, but why put so much drug out into the system.

Our industry does great things for so many people.  The drugs that are abused are important drugs that also do so much good for people.  These pain drugs, tranquilizers and other commonly abused drugs are so critical to medical practice, and I certainly hope they are available if and when I need them.  My concern is the greed that temps us to look away and mind our own business while all this abuse is taking place.

I would love to see a real effort by the industry to change things.  What happens to all the settlement money for marketing practice cases that go to both the states and the federal government?  I would love to see this money go towards a monstrous effort to stop this abuse situation.  Why shouldn’t the government pursue prescription drug abuse with the same intensity they go after the lucrative and highly publicized marketing whistleblower cases?  Why aren’t whistleblowers turning in those involved in these abuse situations?  Not enough financial reward for the risk?  Let’s focus and fix this problem and quit looking away.

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