Americans consume 80% of the world's opiates, including 99% of the world's hydrocodone, Dr. Emilie Becker of the Texas Department of State Health Services told the Texas Senate Criminal Justice Committee last week. (Here's the agenda and here's the link to the online video.) In 1990, said Becker, the Center for Disease Control estimated there were 575,000 new opiod users nationally; by 2010 that number had mushroomed to 4.5 million, with the number of drug-related deaths rising with use. She presented this striking chart to the committee, demonstrating that last year, for the first time, drug overdoses eclipsed deaths from firearms and traffic accidents:
|Via the Houston Chronicle.|
One in five Texas teenagers have experimented recreationally with prescription drugs, said Becker. By far the biggest proportion of opiod use among teens was attributed to kids drinking codeine cough syrup. The volume of prescription drugs presently on the market is vast. Sitting unused in US medicine cabinets, she said, is "enough hydrocodone to medicate every American adult 5 mg every 4 hours for 1 month "
Becker's primary suggestions involved better coordination between state regulators and law enforcement, and she agreed with other speakers that the Legislature had so recently passed new enhancements on these topics that one couldn't yet judge the impact of changing the law or what additional changes might be beneficial. But she emphasized that she wanted to target not just doctors at "pill mills" but also physicians who prescribed the pills (presumably in good faith) as part of their regular practice. That seems to step pretty quickly into dicey territory, especially for Republicans who spent the last two years bashing government interfering with the doctor-patient relationship or dictating medical care to physicians.
DPS Col. Steve McCraw continued with the tough talk, declaring, "A pusher is a pusher, a drug trafficker is a drug trafficker whether they've got a lab coat or what." However, he agreed the new laws haven't yet had tie to be fully evaluated and recommended staying the course, though at Sen. Huffman's insistence he said that if the Legislature chose to prioritize this task, it could pony up for more investigators at the agency to target doctors.
Judge Ryan Patrick, son of committee member Sen. Dan Patrick, was appointed by Gov. Rick Perry as a Houston-area district judge, but before that he was prosecuting prescription drug cases. He praised DPS for retraining narcotics investigators to monitor the state's prescription tracking program for doctor shoppers. Thanks to that shift in resources, the Harris DA saw a doubling of cases filed, all with "incredibly high" clearance rates. Most of them focused on people who go to 30-40 doctors and/or pharmacies per month, he said. "The evidence on these cases was terrific."
Prosecuting pharmacists remains difficult, he said. It requires the DA's office dealing with the administrative boards, which they'd never done before, and administrative regulators to cooperate with law enforcement more than they're used to. It's easier in some instances to prosecute patients. Under the recently enhanced statute, he said, a patient commits a felony if they go to a new doctor for a prescription and don't notify their old one.
Finally, Jeannette Moll from the Texas Public Policy Foundation said that this is a different type of crime because most purchasers didn't purchase the drugs illicitly. She called for a statutory presumption that offenders convicted of possession be sentenced to treatment instead of prison. The presumption would not apply to trafficking crimes nor where the judge thinks the defendant poses a danger to society, she suggested. She also advocated a "Good Samaritan" exception be crafted to prescription drug statutes to encourage people to call 911 in response to an overdose.