Remarks of The Honorable David J. Hickton
at Forensic Fridays
A CLE and Professional Education Seminar Series
Death by Medication: Investigating the Prescription Drug Abuse Epidemic
Good afternoon. I welcome and thank you for attending today's Forensic Friday presentation. Your participation is testament to your interest in addressing the fastest-growing drug problem in the United States - prescription drug abuse.
The non-medical use of prescription drugs contributes to nearly 40,000 deaths and almost $200 billion in health-care costs annually. Drug-induced deaths are the number one cause of death in America. More Americans are dying from drug-induced deaths than from traffic fatalities.
In fact, the Centers for Disease Control has labeled prescription drug abuse "an epidemic."
Many Americans benefit from the appropriate use of prescription pain relievers, but when abused, they can be as addictive and dangerous as illegal drugs. Opiate-based painkillers, such as oxycodone, are among the most commonly abused drugs. Many misperceive that these drugs are safer than heroin or other illicit street drugs, because these medications can be effective for the treatment of serious pain; are produced by legitimate companies; and, may be lawfully prescribed.
However, these drugs can be harmful – and even fatal – when used inappropriately. They are highly addictive and the effects of the addiction are frightful and devastating. When trafficked and abused, these pills are as wicked as stamp bags of heroin, and require decisive law enforcement action.
According to the 2010 National Survey on Drug Use and Health, two-and-a-half times more Americans currently abuse prescription drugs versus those using cocaine, heroin, hallucinogens, and inhalants combined. And while youths and young adults, aged 12 to 25, are the most frequent abusers; this problem affects all age groups, all ethnic groups, men, women and children, and it is destroying lives and killing people.
That young people consider prescription drug abuse as a "low risk" way to get high is disturbing. And the fact that the majority of those 12 and older who abused pain relievers in the past year obtained them from friends and family for free, including from their home medicine cabinets, should be cause for alarm.
According to the Office on National Drug Control Policy, 478 million prescriptions for controlled-substances were dispensed in 2010. And more than 7 million Americans reported current non-medical use of prescription drugs. One in four people using drugs for the first time in 2010 began by using a prescription drug non-medically.
The public health impact of opiate analgesic abuse is staggering. For every one unintentional opioid overdose death (in 2009) there were 11 abuse treatment admissions; 41 emergency department visits for misuse or abuse; 148 people with abuse or dependence issues; and 419 non-medical users.
These statistics point to the pressing need to take a stand against the prescription drug epidemic. The U.S. Attorney's Office has been and will continue to make prescription drug abuse one of our highest priorities by targeting the illegal supply chain at every level. Doctors, pharmacists, nurses, technicians and traffickers should be on notice...if you are illegally prescribing, dispensing or distributing prescription pills we are coming after you. The full force of the United States Attorney's office, the DEA, the FBI, the Pennsylvania Attorney General's office and every municipal police department is resolved to expose and take down these criminals who threaten our community.
As evidence of our office's commitment in Western Pennsylvania, over the summer alone:
- Peters Township Doctor Oliver Herndon pleaded guilty to illegally prescribing thousands of oxycodone pills to as many as 135 individual patients a day over more than a year.
- We shut down a heroin and oxycodone pipeline moving large quantities of these drugs from Detroit to Johnstown. Two of the defendants were recorded laughing about how addicted buyers will pay anything - even up to $150 - for a single oxycodone pill.
- We charged a nurse at the Department of Veterans Affairs Medical Center who fraudulently obtained numerous hydrocodone pills.
- We obtained a guilty plea from a pharmacy technician in Erie, who admitted to stealing more than 80,000 hydrocodone tablets and altering the computer records to help hide the thefts.
- We added three new defendants to an indictment that charges members of a trafficking ring in the New Castle area with conspiring to distribute large amounts of oxycodone. One of the original defendants, a Florida resident, pleaded guilty in July to supplying the organization with tens of thousands of pills.
- Finally, another Florida man was sentenced to federal prison for mailing hundreds of narcotic painkillers through the U.S. mail.
The commitment of the Federal government to address this problem has never been higher, and the administration has adopted an enlightened and progressive approach to the drug problem, employing a balance of public health and safety perspectives.
Gil Kerlikowske, Director of National Drug Control Policy, said at a recent speech in North Carolina:
"As a former police chief, I've seen the devastating effect that substance abuse can have on people, families, and communities. But I also know that we cannot arrest our way out of the drug problem. Law enforcement will always play an important role in bringing criminals to justice, but we cannot—and do not—respond to substance dependence with incarceration."
"That's why my office’s most recent Strategy allocates $10.1 billion for drug prevention and treatment programs—more than we allocate for U.S. law enforcement and incarceration. This Administration understands that substance dependence is a health issue not necessarily a criminal justice issue—and we support innovative ways to bring treatment to people who need it most."
Attorney General Eric Holder has made prescription drug abuse one of the Justice Department's top priorities. At an Opiate Abuse Conference in Vermont, AG Holder said,
"When it comes to effectively preventing, reducing, and combating drug use – and, in particular, the abuse of opiate-based prescriptions – there is no one path to engagement. And, unfortunately, there is no single or sure solution. If we are going to succeed in protecting the health and safety of our communities, if we are going to arm our neighbors – and, especially, our children – with the information they need to make good choices, we need a variety of perspectives and approaches.
"For me, the issue of drug abuse, and the fight against drug-fueled crime and violence, has been a personal and professional concern for decades. As a prosecutor, as a judge, as a U.S. Attorney, and as the Deputy Attorney General, addressing the causes and consequences of drug abuse was at the forefront of my work. Today, as Attorney General and as a parent, it remains a top priority."
The White House Office of National Drug Control Policy in its 2011 Prescription Drug Abuse Prevention Plan established clear goals for reducing drug abuse. As the Justice Department takes steps to help implement this strategy, our efforts are focused on:
- educating parents, youth, patients and prescribers on how to recognize and address the signs of prescription drug abuse;
- empowering law enforcement to eliminate improper prescribing and dispensing practices; and
- ensuring that quality drug treatment programs are available and accessible.
The entire U.S. Attorneys’ Community is joining the Partnership at Drugfree.org to promote its multi-year campaign entitled the ‘Medicine Abuse Project.’ The campaign will kick-off on September 23rd, with Wake Up to Medicine Abuse Week, an intensive media blitz that will both encourage and help parents and the public-at-large to take action and provide an opportunity for properly disposing medications during the Drug Enforcement Administration's National Prescription Drug Take-Back Day on Saturday, September 29th. This will be DEA’s fifth time collecting unused, unneeded, and expired prescription drugs. The U.S. Attorney's office partners with DEA on this effort, and I was both astounded and encouraged by the number of cars pulling up to the drop-off points.
On June 27, the U.S. Attorney's Office held the first Western Pennsylvania Prescription Drug Abuse Summit at Washington & Jefferson College. More than 200 experts from the medical profession, education, insurance, treatment and law enforcement communities attended the afternoon session and another 100 concerned citizens joined us for the evening presentations. Participants came together to examine the prescription pill abuse issue, and to discuss potential ways to address this epidemic. Regina Labelle, Chief of Staff for the Office on National Drug Control Policy, discussed how her office is responding to America's prescription drug crisis. We also heard from a former school teacher and recovering addict who shared how she moved from prescription pills to heroin to stealing from her employer and robbing a bank to support her habit, and from a father who lost his son to opiate abuse days before his high school graduation.
When we first announced the summit, the response I received was overwhelming and far exceeded that of any other program or event we have undertaken. I believe that is because everyone knows someone who has been touched by this problem.
Last year in Allegheny County more than 200 deaths resulted from drug overdoses, with opioids responsible for the majority of these deaths.
And Allegheny County is not alone.
This problem exists in every other county in Western Pennsylvania.
Our recognition, here and in Washington, D.C., of the full dimensions of this problem does not mean we are relenting in our aggressive prosecution of those who traffic in illegal prescription drugs - to the contrary, we have doubled-down on the prosecution of these crimes.
It is a fact that the prescription pill epidemic cannot be solved by law enforcement alone. We all have a role to play. Success will only come from coordination and collaboration at the Federal, state and local levels.
We need to attack both the supply and demand for these illegal drugs. We must make a clear distinction between those who suffer from addiction and those predators who prey upon addicts and profit from the sale of illegal drugs. We must remove the stigma of drug addiction and show people that they can recover. We must develop new strategies, which include better treatment options founded upon the recognition that addiction is a potentially deadly condition and a medical, and often, a mental health problem.
You are about to hear from experts at every level of the issue. Dr. Dixon, former director of the Allegheny County Health Department; Professor Fred Fochtman, a pharmacist and former chief forensic toxicologist for the Allegheny County Coroner's Office: Professor Mary Mihalyo, assistant professor of pharmacy practice at Duquesne University; and my friend, Dr. Cyril Wecht, whose expertise has been sought on the drug-related deaths of celebrities and citizens alike.
I want to commend them, and you, for being here today. Your work plays a critical role in addressing the prescription drug problem in our region. With your continued support and commitment, we will continue to make a safer, healthier Western Pennsylvania.