The Commerce, Manufacturing and Trade Subcommittee of the House Energy and Commerce Committee held a hearing to discuss regulation and prevention of prescription drug diversion and abuse in the U.S.
The hearing began with the testimony of Office of National Drug Control Policy Director Richard G. Kerlikowske. He explained the Administration’s Comprehensive Prescription Drug Abuse Prevention Plan, which focuses on education, monitoring controlled substances through strengthened state programs, safe disposal of medication and improving law enforcement's capability to prevent diversion.
Next, the committee addressed state reform efforts to fight diversion and abuse and also the work of the Drug Enforcement Administration Office of Diversion Control. Witnesses included Florida Attorney General Pamela Jo Bondi, Kentucky Attorney General Jack Conway, Ohio Senior Assistant Attorney General Aaron E. Haslam and Drug Enforcement Administration Deputy Assistant Administrator Joseph T. Rannazzisi.
The DEA Office of Diversion Control is specifically dedicated to tracking and preventing diversion of prescription drugs. It does so through monitoring entities that supply, prescribe or dispense controlled substances.
The committee discusses that office's efforts to fight prescription drug diversion and abuse, how its success is measured, its cooperation with state and local law enforcement and the adequacy of its current reporting system.
In a 2010 survey, law enforcement agencies at the state and local levels identified controlled prescription drugs as their greatest drug threat.
At the state level, as of June 2011, 48 states had adopted Prescription Drug Monitoring Programs (PDMP), but not all are funded or effective, according to news reports. The programs use a state-wide database to identify, deter and prevent diversion and abuse.
Some states have adopted additional prescription drug legislation. In July 2011, Florida adopted a law that banned doctors and pain clinics from selling prescription painkillers and the total number of Oxycodone pills prescribed in the state dropped by 97 percent, according to news reports.
Texas adopted a law in 2010 targeting "pill mills," but it has seen less success. It requires clinics to register and submit to inspections by the Texas Medical Board if half of the patients seen are given controlled prescriptions, but prescribers are finding ways around the new law, according to news reports.
Florida Attorney General Bondi spoke about the success of Florida's legislation thus far. She said prior to Florida's presciption drug legislation, 90 of the 100 biggest Oxycodone prescribers were in Florida and since then that number has dropped to 13.
She acknowledged that Florida still has a long way to go and is dedicated to continuing to fight the problem. The next problem she plans to tackle is the large number of babies being born addicted to opiates.
Kentucky Attorney General Conway testified that the most important thing that Congress can do to fight the prescription drug problem is to implement PDMPs in all states that work together.
DEA Deputy Assistant Administrator Rannazzisi said that despite the significant decrease in the number of pill mills in Florida, the numbers across the rest of the country are climbing. He discussed how the DEA uses a reporting system called “ARCOS,” or the Automation of Reports and Consolidated Orders System, to monitor controlled substances from manufacture to sale.
The committee also examined what steps are being taken to combat diversions in the private sector.
They heard from John M. Gray, President & CEO of the Healthcare Distribution Management Association; Joseph H. Harmison, R. Ph. Owner of DFW Prescriptions on behalf of the National Community Pharmacists Association; Kevin N. Nicholson, R. Ph., Vice President of the National Association of Chain Drug Stores; Kendra A. Martello, Assistant General Counsel of the Pharmaceutical Research and Manufacturers of America; and David Gaugh, R. Ph., Vice President for Regulatory Science of the Generic Pharmaceuticals Association.