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 Earlier this week, the White House unveiled the nation's first comprehensive plan to curb prescription drug abuse. Federal lawmakers also recently introduced legislation to crack down on so-called "pill mills," which illegally distribute massive amounts of prescriptions.

The federal focus on prescription drug abuse could bring more funds and other resources to local law enforcement, U.S. Attorney Booth Goodwin said Wednesday.

He added that the national attention could be just as helpful as money, because it could show what "other parts of the country can do to help address the very real difficulties that we face here in Appalachia." 

Pill trafficking reaches across state borders, he said, with drugs flowing into West Virginia from areas such as southern Florida and Detroit.

West Virginia has the nation's highest rate of drug overdose deaths. Of those, more than 90 percent involve prescription drugs.

 For the past six months, the White House Office of National Drug Control Policy worked with federal agencies to develop the strategy announced this week. The plan seeks to reduce prescription drug misuse by 15 percent over the next five years. 

 In February, national drug policy director Gil Kerlikowske visited West Virginia as part of a tour through Appalachia. He stopped in Charleston for a summit organized by Goodwin's office, and in Huntington for a community roundtable discussion hosted by Sen. Jay Rockefeller, D-W.Va. 

 "He obviously listened, and there are some very good practical solutions in that plan," Goodwin said.

 The White House proposal touches on four areas:

 Opiate painkillers are the most commonly abused prescription drug.

 Among other things, the national strategy includes increased training for health providers on recognizing substance abuse and prescribing opiate medications; more training for police; and a nationwide public education campaign. 

 Drug manufacturers would have to develop educational material for patients about the proper use and disposal of opiate painkillers.

 The plan is comprehensive, but will take money to make a difference, said Mike O'Neil, a pharmacy professor at the University of Charleston and an expert on the diversion of prescription drugs.

 "All these things are very, very good," O'Neil said, "but the funding needs to be there."

 The White House released the plan as some members of Congress push for legislation called the Pill Mill Crackdown Act of 2011. Democratic Rep. Nick Rahall and Republican Rep. David McKinley, both of West Virginia, are co-sponsors of the bill. 

 The bill would triple fines for pill mill operators, from $1 million to $3 million. It would double prison sentences from 10 years to 20 years.

 "The laws, no matter how good they are, are only good if they are used," O'Neil said. "We have seen, not just in West Virginia, but also in many other states, that often times there's not aggressive enough prosecution against many of these practitioners."   

 The tougher punishment could prevent people from starting up pill mills, but it's unlikely to stop those who already run them, O'Neil said. 

 "They're not going to worry about getting caught," he said, "since greed is the main factor here."

 O'Neil praised provisions in the bill that would seize assets from pill mills and devote them to drug treatment programs and prescription monitoring databases.

 The legislation also would reclassify hydrocodone combination products - those made with drugs such as acetaminophen -- to make them harder for people to get. Hydrocodone, which is sold under brand names including Lortab and Vicodin, is the most abused painkiller nationwide.

 "That potentially creates problems for people who are on [long-term] opiate therapy for back pain, cancer pain," O'Neil said.

 In the past, mail-order pharmacies have fought efforts to reclassify hydrocodone products, O'Neil said.

 "It'll be interesting to see who comes to the table against this, because it does affect incomes of major retailers and mail-order" pharmacies, he said.

 In fighting prescription drug abuse, policymakers need to strike "a delicate balance" said Evan Jenkins, a Democratic state senator from Cabell County and executive director of the West Virginia State Medical Association.

 "From the physician's perspective, there is no sympathy or patience for doctors who are running pill mills or prescribing inappropriately for whatever reason," he said. But "we must be careful that we are not curtailing clinically appropriate treatment for patients in need."

 Because many people legitimately need these medicines, curbing prescription abuse is not as simple as a "just-say-no-to-drugs kind of campaign," Jenkins said, adding that greater access to substance-abuse treatment programs needs to be part of the discussion.

 "These are very effective medications when properly used, and they are literally lifesavers to patients in serious chronic pain or end-of-life care, like cancer victims," he said.

Reach Alison Knezevich at alis...@wvgazette.com or 304-348-1240.