Las Vegas Sun

October 1, 2014

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President cites Nevada’s drug-monitoring program

Nevadans addicted to prescription drugs have re-injured their own broken limbs, lied about their children having attention deficit disorder and forced their kids into telling doctors they're in pain in order to get their hands on their pills of choice, authorities said.

President Bush's national anti-drug strategy, announced Monday, for the first time targets the use of pain relievers, sedatives and stimulants, a problem that has spiked in the past decade.

Under the strategy, the government will pay states to help develop electronic monitoring systems to track patients' drug use and flag cases showing patterns of abuse, such as "doctor shopping," where a patient gets prescriptions from multiple doctors.

Nevada instituted a prescription monitoring system in 1997 and it is profiled in Bush's 62-page strategy.

Twenty states have monitoring programs and 11 more may adopt such programs next year.

Most other states use their monitoring program as a law enforcement tool, but Nevada doesn't voluntarily share information with law enforcement, Keith Macdonald, executive secretary of the Nevada State Board of Pharmacy said. The board does provide records upon the request of police under certain circumstances.

Instead, Nevada takes a rehabilitative approach to prescription drug addiction.

"I think it's good public policy," Macdonald said. "If we arrested everybody, you might ruin a life rather than help" the drug abuser.

Pharmacies in Nevada are required to download prescription information to the state's Prescription Controlled Substance Abuse Prevention Task Force, which electronically scans though the data looking for suspicious patients.

The system red flags patients who "doctor shop" and those who are being prescribed large amounts of certain drugs in short periods of time.

The task force sends letters to each of the patient's doctors and pharmacies asking them to intervene and refer the patient to addiction or pain management specialists.

In 2001, there were 2.4 million prescriptions written in Nevada. Of those, the task force identified 8,395 as suspected abusers.

The numbers showed no significant change in 2002, the most recent statistics available.

That year, 2.7 million prescriptions were written in Nevada. Of those, the state task force identified 8,253 as suspected abusers.

However, these numbers don't tell the whole story.

Prescription drug abuse is difficult to quantity but it is on the rise in Nevada, police and addiction specialists say.

Abusers of prescription drugs use other methods to obtain the narcotics, including the Internet, traveling to other states and Mexico.

"It's a very significant problem at all levels of society," said Dr. Michael Levy, a Las Vegas addiciton medicine specialist, adding that he treated a couple that spent $40,000 on illegal prescription drugs last year.

About 50 percent of Levy's practice involves people addicted to prescription narcotics, he said.

Hydrocodone, sold under the brand names Vicodin, Lortab and others, is by far the most illegally obtained prescription drug, according to the pharmacy board's records, followed by Xanax and Soma.

Levy sees more patients seeking help for hydrocodone addiction than any other drug. Painkillers containing oxycodone, such as OxyContin and Percocet, are other top abused drugs.

OxyContin, a powerful drug used to treat cancer pain, is widely abused in the Appalachian states, but Macdonald said fraudulent OxyContin prescriptions "hasn't been that big of a problem here. Doctors haven't prescribed it here as much probably because they became more aware of the abuse."

OxyContin is still being abused, but addicts are apparently finding other ways to obtain it, others say.

"It's everywhere. It's a street drug," Levy said.

Capt. Stavros Anthony, head of the Metro Police narcotics bureau, said OxyContin is probably the most common prescription drug abused in Las Vegas, although prescription drug abuse is dwarfed by the abuse of narcotics such as marijuana, cocaine and heroin.

One way addicts obtain prescription narcotics is by stealing prescription pads from doctors, Anthony said.

Investigating prescription drug cases is more challenging that investigating cocaine or heroin cases, he said. If a person is caught with those drugs, it's clear right away that they are illegal. But with prescription drugs, it may not so obvious.

"We would have to talk to the pharmacy, the doctor and do a much more thorough investigation," Anthony said.

Police themselves aren't immune to falling into a prescription drug addiction.

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