CHARLESTON, W.Va. -- Every day, pharmacies become the scene of an ongoing crime undermining our society. It happens right before everyone's eyes with little notice until it is too late.
While the nation is often fixated on the crime of drug trafficking that involves guns, violence and raids, prescription drug abuse accounts for almost 30 percent of overall drug abuse in the United States. The Centers for Disease Control and Prevention cite it as one of our fastest growing drug problems and labeled it a "silent epidemic." In West Virginia, drug overdose deaths now outnumber fatal car accidents.
I've spent more than my fair share of time in a courtroom, as a clinical and forensic psychologist, trying to make sense of sometimes senseless acts and doing my part to help laws be applied fairly. As a West Virginian and a father, I'm worried about this epidemic. How has the abuse of prescription drugs gotten so out of hand? In too many cases, both users and dealers have learned how to game the prescription drug system to get large amounts of the most addictive drugs from pharmacies and physicians across the state.
First, you need a prescription from a doctor, any doctor. In rare cases, unscrupulous doctors may write multiple prescriptions seeking financial gain from dealers. More often, a user will visit multiple well-meaning doctors who write them multiple prescriptions, a practice known as "doctor shopping."
Next on the checklist is the method of payment. Those looking to evade systems put in place by health plans or by local drug monitoring programs use cash -- not insurance -- to pay for these pills. When an individual uses public or private insurance to help pay for the prescription, that transaction is tracked by sophisticated systems to detect waste, fraud and abuse. But when cold, hard cash is used, these detection systems are avoided. This creates a "cash loophole" -- a loophole that ought to be closed. The Drug Enforcement Agency and other law enforcement groups draw a direct line between the prevalence of cash transactions and the black market diversion of prescription drugs.
Third is supply. Retail pharmacies dispensed 174 million prescriptions for addictive painkillers such as Oxycontin and Vicodin in 2000. Nine years later, 257 million prescriptions were dispensed, an increase of 48 percent. While some growth can obviously be attributed to population growth, it also demonstrates why prescription drug abuse is increasing as a problem.
West Virginia knows too well the problems associated with prescription drug abuse. State leaders have led efforts to combat this drug abuse that is increasingly affecting our communities.
So what can we do about it? Policymakers at every level deal with this issue every day, and real progress is being made as awareness of this problem intensifies. But our law enforcement agencies simply need more tools.
One relatively low-cost step would be to close that "cash loophole" by having pharmacies process cash transactions through a version of the existing health-plan system meant solely to provide appropriate law enforcement officials with real-time trend data on where these cash transactions are happening and what the source of those prescriptions are.
The DEA sees cash transactions as giant red flags that signal an increased likelihood of illegal behavior. Other strategies, like educating our kids about the dangers of these drugs and our parents about how to safely dispose of them, can help drive down demand.
We all need to open our eyes to the prescription drug abuse epidemic, and support those who are on the front lines fighting to end it.
Clayman is a clinical and forensic psychologist and director of Clayman& Associates in Charleston.