Federal drug czar wants Missouri to set up drug tracking program

ST. LOUIS -- While heroin, methamphetamine and even synthetic drugs tend to get much of the attention, the nation's drug czar says prescription drug abuse is far and away the most lethal drug problem in America.

Monitoring programs adopted in 49 states are helping address the problem of prescription drug abuse, White House Office of National Drug Control Policy director Gil Kerlikowske said. The lone holdout is Missouri, where Kerlikowske plans to be today to push for such a program.

Kerlikowske called prescription drug abuse an "epidemic." Nearly 21,000 deaths in the U.S. were attributed to prescription drug overdoses in 2009, the most recent year with statistics available.

"The number of deaths as a result of prescription drug use and abuse are greater than heroin and cocaine overdose deaths combined," Kerlikowske said.

Kerlikowske is scheduled to be in the St. Louis suburb of Fenton today. Among those meeting with him will be state Sen. Kevin Engler, a Farmington Republican who has unsuccessfully pushed for a state program.

Engler said he'll try again in 2013. But the chief opponent, Republican Sen. Rob Schaaf of St. Joseph, said he's willing to pursue another filibuster like the one that killed Engler's proposal this year. Schaaf said the databases reveal sensitive information that many people don't believe the government needs to know.

"All they have to do is punch in your name and address and they can find out every controlled substance you've been prescribed," Schaaf said this week.

The Office of National Drug Control Policy said the number of deaths from prescription drug overdoses has increased fourfold over the past decade. Addictions are up sharply, too. Sometimes people being treated for legitimate pain become addicted, Kerlikowske said, but in many other cases people looking to get high turn to prescription drugs.

Some start by stealing drugs from relatives or friends. "That's why they're now producing medicine cabinets with locks," Kerlikowske said. "Realtors will tell you to clean out your medicine cabinet before an open house."

Many prescription drug abusers eventually "doctor shop" -- that is, search out physicians who will give them prescription drugs to feed a habit. Kerlikowske said that's where monitoring programs are helpful.

The programs involve electronic databases that can identify when a person is going to multiple medical offices to obtain prescriptions. State licensure boards can also use the databases to identify so-called "pill mills," or doctor offices that overprescribe medicines.

Florida was once known as the pill mill capital. Just a few years ago, more than 90 of the nation's top 100 prescription-dispensing physicians were in Florida. That was before the state instituted a tracking program in 2009.

"Now they're down to 13 of the top 100," Kerlikowske said. "Many of those [pill mills] have been opening offices in Georgia, Kentucky and Missouri."

Engler said, "That's why we're turning into the pill mill capital of the country."

But Schaaf, a family physician, said he doesn't believe the databases are effective, noting the increasing number of overdoses and deaths despite the rising number of statewide monitoring programs.

Kerlikowske and Engler say the problem is too significant to ignore and monitoring is useful.

"The doctors that use them call it a real patient safety tool," Kerlikowske said.