Jay chairs Senate hearing to examine prescription drug abuse

Sen. Jay Rockefeller, D-W.Va, chaired a Senate hearing Thursday morning to examine growing prescription drug abuse in West Virginia and across the country.

The Senate Finance Subcommittee on Health Prescription Drug Abuse hearing focused on how the federal Medicare and Medicaid programs are working to counter the problem.

The federal Centers for Disease Control recently called the problem an "epidemic." Overdoses from prescription drugs have become one of the leading causes of accidental death throughout the country.

"Prescription drug abuse is what happens when prescription drugs are used for non-medical purposes," Rockefeller said. "Opioid painkillers, anti-psychotics or stimulants are most commonly used."

Between 2001 and 2008, Rockefeller said, the death rate involving overdoses of legal prescription drugs more than quadrupled.

For every death from a prescription drug overdose, 10 people are admitted to hospitals, 32 people visit emergency rooms, 130 people become addicted to these drugs and 825 people take them for no medical reason, the CDC discovered.

"Prescription drug abuse touches people from all walks of life," Rockefeller said. "Prescription drugs can, and do, work wonders for millions of people. For people with conditions like chronic pain or severe mental illness, prescription drugs can be a godsend."

But the increasing availability of prescription painkillers has not been accompanied by more effective monitoring programs, especially across state lines, or by better education programs for patients who use them.

Sen. Joe Manchin, D-W.Va., praised Rockefeller for holding the hearing.

"The drug problem has reached epidemic proportions. I don't know of a family that hasn't been affected -- either directly or indirectly. ...

"The problem of prescription drug abuse is tearing our families apart, damaging our communities and hurting our workforce. Along with the work of Rep. [Nick J.] Rahall, we're trying to bring all the parties together to eliminate the scourge of drug abuse in West Virginia and across the country," Manchin said.

Prescription drugs, Rockefeller stressed, are so powerful and addictive that they are widely marketed illegally.

"These criminals are worse than ordinary fraudsters. They not only steal taxpayer dollars through fraudulent schemes like 'pill mills' or fraudulent prescriptions, [but] they also feed people's addictions and prey on their pain."

Sen. Charles Grassley, R-Iowa, said, "The Office of National Drug Control Policy describes prescription drug abuse as the nation's fastest growing [medical] problem.

"Over-prescription strains the financial ability of Medicare and Medicaid, including drugs like oxycodone and hydrocodone."

Grassley said the federal Centers for Medicare and Medicaid Services [CMS] has "been an absent partner in controlling abuse. The cost of doing nothing is already too high."

Jeffrey Coben, director of West Virginia University's Injury Control Research Center, testified, "The alarming increase in prescription drug abuse is clearly a crisis that demands our attention.

"As a practicing emergency physician, I have seen the pain and torment of families, of children removed from their homes, of shootings, stabbings and suicide from drug abuse."

Painkillers also play positive roles, Coben added.

"In many cases, providing adequate pain relief can be the best thing we can do to help our patients," he said. "Balancing the appropriate use of prescription drugs and preventing their abuse is a complex and difficult challenge. We also need to adjust societal views of the recreational use of prescription drugs."

Coben urged greater efforts to prevent "doctor shopping" by people seeking to increase access to painkillers.

During his eight-hour shift Wednesday, Coben testified, he saw "half a dozen patients struggling with pain and medication issues.

"Part of the problem is our fragmented primary care system. Some patients seek drugs for pain and others for recreational use. We need to understand what a patient needs at the time we provide them care."

Timothy Schwab, chief medical officer for the SCAN Health Plan in Long Beach, Calif., said his group serves more than 128,000 people, primarily seniors.

"When a new member enrolls, physicians have little awareness of medications being prescribed from other physicians," he said.

Schwab encouraged better efforts to coordinate care through medication management programs involving physicians, nurses, pharmacists and geriatric care managers.

Billy Millwee, state Medicaid director for the Texas Health and Human Services Commission, praised his state's management system for foster children.

"Since 2005, we have seen a tremendous reduction in psychotropic drugs used by foster children.

"We also identify clients who have a pattern of drug-seeking behavior," Millwee testified. "We have a lock-in program, that locks patients into a particular pharmacy, so we can monitor their prescriptions.

"Texas is also very active in promoting electronic medical records," he said. "But it is not enough to identify over-prescribers.

"We found one Texas physician who defrauded Medicare and Medicaid out of $375 million. When you identify a bad practitioner, you need to pass that on to state authorities and the Centers for Medicare and Medicaid Services."

The physician, Jacques Roy, was charged with masterminding a fraud conspiracy over the past six years, according to the Washington Post.

At the end of the hearing, Rockefeller praised the health legislation Congress passed two years ago Thursday, for setting aside $10 billion for new rural clinics.