Malibu Beach Recovery Center

I don’t know if this is happening on the West coast, but on the East coast, 11 hospitals in New York City are tightening up their Emergency Room policy regarding how many prescription pills can be dispensed.  Just as the flu was declared an epidemic in New York state, Mayor Michael Bloomberg took action to stop what he called a “citywide and national epidemic of prescription drug abuse.”

Soon, patients won’t be able to get more than three days’ worth of Vicodin and Percocet and other narcotic painkillers. They can’t get Fentanyl patches or methadone, and if they have stolen, lost, or destroyed prescription, they’re out of luck, according to the NYT article. The policy is already in place in Utah and Washington state.

The goal is to stop people from selling pills from medicine cabinets on the street or abusing them themselves, and reduce drug abuse overall. Of course, opponents argue that the poor and uninsured will suffer from this because the ER is often their only access to medical care. And some people with true pain need more than three days’ worth of pain pills. What if they’re waiting for surgery and in pain? 

Not to be outdone by the mayor, a few days later Raymond Kelly, the NYC Police Commissioner proposed that more pharmacies use fake prescription drug containers with GPS devices attached (called bait bottles) to deter thefts. (The idea is that knowing they might take one of  these bottles would be enough to stop robbers who are after painkillers and other addictive medications.) The fake bottles would be placed in groups of legitimate containers.

The authorities could track the bottle if there’s a robbery, and hopefully find “stash locations.”  Purdue Pharma is supplying the GPS devices, undoubtedly hoping for some positive PR since the company sells Oxycontin. 

The practice has actually been tried in other places in the country, but the police commissioner is hoping that thousands of pharmacies will be involved this time. He mentioned that the black market for oxycodone as the impetus for his proposal, and recalled the 2011 pharmacy robbery in Long Island by a man high on oxy who killed four people. He also mentioned a retired NYPD officer who became addicted to pills and then robbed pharmacies at gunpoint. 

The end of the article had an interesting anecdote of how this practice has worked. In 2010, a robber after oxycodone threatened to shoot a pharmacy employee in Maine. But the employee was able to include a bait bottle in a bunch of bottles the robber took, and the police were able to track the thief and arrest him.

I didn’t know about the bait bottles, and the ER restrictions only make sense. Recently the government offered a reward for anyone who can come up with a way to thwart those horrible robocalls (for instance, from Rachel at Card Services) because they can’t find a remedy themselves. Maybe they should offer rewards for good ideas like these two for stopping robberies and drug abuse.

Even in 2007, pill mills, or “places where bad doctors hand out prescription drugs like candy”, were hitting media outlets such as the CBS News website.  Pill mills are frequently storefront operations—clinics and pain-management centers that dispense narcotics to people who abuse drugs or people who want to sell them to drug abusers. The CBS News post also explained how they work: they’re cash only, and the operators conduct cursory physical exams and sketchy or mock reviews of patient records. That’s only for starters. There may also be security guards and a long line of people waiting to see the doctor or nurse.

These places are a growing concern. In December, The Gainesville Sun and The Palm Beach Post each had an article on how they’re proliferating in Florida. Also last month, Chris Cuomo reported on the problem in Texas for Good Morning America. Chris Scarborough is the unfortunate Texan in this story who was taken advantage of by unscrupulous doctors, according to his parents. The young man went to a pill mill, got some pills, and accidentally overdosed at age 25.

According to the story, there are 150 of these pill mills in Texas even though legislation has been passed to try and thwart them. It costs $4.00 to buy one hydrocodone pill or another pill containing soma, a muscle relaxer. And as Chris Cuomo so aptly put it, drugs don’t end there, they start there. What’s really sad is that Texan drug dealers, and undoubtedly others, pay homeless people to go in and buy the drugs for them.

I get so angry when I hear these stories. Will we never eradicate the prescription pill problem? What can we do about operations like this? I know the government convenes experts to discuss drug abuse, and there’s testimony before Congress, but we’ve got to do more. This is decimating our families and our children.

California State Senator Mark DeSaulnier is coming to visit the Malibu Beach Recovery Center at the end of July. We are honored and excited.

Senator DeSaulnier is a man after my own heart. Every year he holds a "There Ought to be a Law" contest," inviting members of his Northern California district to submit ideas for new state legislation. We got to know him this year because one of the 2009 winners was Danville resident Bob Pack, whose two children, Troy and Alana Pack, ages 10 and 7, were killed in 2003 when a woman high on prescription medication passed out while driving her car. The car crossed three lanes of traffic, killing Bob’s children and seriously injuring his wife. The driver had gotten 350 vicodin pills in the week before the accident from six different doctors, all of whom practiced at the same hospital. Each of them had no idea that she was getting medication from the others.

Working with the Department of Justice, Pack, an East Bay computer company owner, and advocate for curbing prescription drug abuse, turned the State's antiquated Controlled Substance Utilization Review and Evaluation System (CURES) into a real time online data base. Now doctors can have instant access to prescription drug histories of their patients- which helps prevent doctor shopping for highly addictive controlled substances such as oxycodone, xanax, vicodin, valium. Until now it took healthcare professionals weeks to obtain information on drug use by patients. That delay allowed patients like the driver who killed Pack's children to get large quantities of drugs from multiple doctors for personal use or sale.

With the State of California broke, Pack proposed the legislation that became SB 1071 (SB stands for Senate Bill). It was designed to make the CURES online database financially sustainable by taxing the pharmaceutical companies $0.0025 for each highly addictive narcotic prescribed in California. That’s less than 25 cents a prescription.

On May 5th I took some of our alumni to Sacramento, including prescription drug addicts now in recovery, to lobby for SB 1071.

To our surprise the bill did not get out of the Senate Health Committee. It lost by one vote. The Democrat who Senator DeSaulnier counted on to vote with him, voted against the bill because; according to his office staff, she was opposed to levying new taxes in the current economic climate. Given the amount of revenue the pharmaceutical industry reports each year (over $300 billion in 2007) this was surprising. Maybe not though, considering the number of lobbyists the pharmaceutical industry employs in Sacramento.

Senator DeSaulnier told me that he is committed to making sure the CURES system will remain funded so doctors can continue to find out in real time if their patients are doctor shopping and pharmacy hopping for narcotics. Can’t wait to hear what he has to say on his upcoming visit.