Inside a glass case lies a corpse covered by white fabric. Across the room, a glassy brown medicine bottle labeled ‘Heroin” offers to cure cough, with one or two tablets every two or three hours. The Drug Enforcement Agency’s museum’s exhibit, Good Medicine Bad Behavior describes the national epidemic of prescription addiction and will be open through 2012 in our Nation’s Capital.
A few miles away, Karen Kelly from the Kentucky-based Operation UNITE talks at a meeting on Capitol Hill about beating the medicine cabinet epidemic. Kentucky has been fighting drug diversion for the past 10 years, and Kelly has been instrumental in organizing the addiction-prevention efforts. She has seen addiction devastate entire neighborhoods, leaving 50 percent of children in some districts to grow up without parents. As the epidemic continues spreading across the nation, we asked Kelly a few questions.
Kentucky may be the precursor to the rest of the nation in terms of prescription abuse. You‘ve been fighting it for a decade. How did this program get started?
Operation UNITE was launched in April 2003 by U.S. Congressman Hal Rogers, who called people together to brainstorm a way to fight the prescription abuse. He called judges, social workers, parents who’d lost kids, police officers and educators, and they came up with the UNITE plan. We got a call from a grandmother raising her grandkids, and she asked if we’d come visit, so we did. She had three grandkids and she couldn’t let them play in the yard because of the drug dealer next door would offer them pills and needles, often throwing them into the yard.We spent most of 2003 just getting access to funding and hiring people, then we kicked off in 2004. We started strong in newspapers with a law-enforcement front. We started organizing one of the biggest drug roundups, and arrested 200 people in one day. We didn’t want to jam up the court system, so we began creating treatment programs to give addicts the choice of rehab. Now we have at least one drug court in every single county. So if people are arrested, they have the option of drug court, where they’re drug tested regularly, they meet with a judge, and with a treatment counselor for 18 to 20 months. From there we started our hotline, town hall meetings, building a community of volunteers.
What advice would you give to other states thinking of implementing similar programs?
First, go out of your way to educate the medical profession. Most prescribers want to do the right thing but they’re not educated about addiction. We have some volunteers on the medical advisory counsel who say, “Every 10 years I get HIV training, and I haven’t seen one HIV patient yet, but today 80 addicts walked through my door and I can’t tell who’s who.”
Second, even if you can’t organize law enforcement and education, convene a meeting and to see where you can forge key alliances, to see how these different groups can work together. For example, the largest insurer in our state offers volunteers for our drug-free summer camp, that’s a tremendous resource, they also donated lock boxes for medication.
Third, get law enforcement and treatment to start working together with education; it takes all three working together to tackle this. Law enforcement runs into a lot of addicts who need help, and they refer them for treatment. Education means using creative ways to reach the public. Ask the dry cleaners to put short anti-fraud messages on coat hangers, go to civic clubs and talk to people about locking up drugs, and know the signs that your kids are starting to struggle. We go region by region targeting the biggest employers in each county, and offering free anti-fraud training lunches. We say, “Have your employees bring lunch we can spend an hour teaching them how to recognize addiction in their kids or colleagues.” Volunteers teach that class; they want to do it because they’ve been affected by the problem somehow. You have to use all your resources.
If you could go back and change something, what would you change, or warn others against?
I wish we’d gotten our healthcare providers onboard before we made a show of law enforcement, because after that happened, the doctors didn’t trust us to talk. A lot of doctors didn’t feel a need to get involved with the issue until a doctor was killed by an addicted patient.
The prescription-drug epidemic is escalating. What would you attribute this to?
Ease of access, and pill mills. Kentucky recently passed legislation to stop pill mills. Doctors will be educated in Kentucky. New clinics will have to be doctor-owned. The problem is not socioeconomic at all; it’s affecting every family in our region no matter what their background. Prescription abuse also is a different type of investigation,― anybody could be a drug dealer, and we have many that are wearing white coats.
You got corporate funding for some of the programs, like the summer camp sponsored by Toyota. How would you advise that other states to get funding like this?
I would say don’t give up. A lot of employers have been impacted by the problem, so our state sees it as a really good benefit for its dollars because it costs more money to ignore the problem. Also leave no stone unturned. Even insurers are recognizing how big a deal this is, so they’ve decided to help us fund our initiatives. Even if its not their mission, it still impacts that family or that company or that organization. And there are government dollars; we had a CDC grant to implement wellness programs. Most states get CDC funds, but don’t use them to stop prescription abuse.
What can be done about the problem nationwide?
As Florida has gotten stricter on its pill mills, people are turning to Georgia and Nashville for meds. We need a pill-mill crackdown act on the federal level, because we know that what Florida did has had an impact. Kentucky and Ohio have passed laws, but how long is it going to take for every state to get onboard? There really aren’t any good reasons to have cash-only pain clinics, with bouncers, for example. We need to educate doctors. Everybody also has a responsibility to know what they are being prescribed, and parents have a responsibility for their children, to know where they are and who they’re with. A lot of addicted teens call us and say that if they drank alcohol, their parents could smell it. So our parents have got to be educated. We have parent trainings where kids tell the parents, “This is how I duped my parents.” Many times the parents are stunned. Then we did focus groups to find out what parents wanted to learn, and made it part of the curriculum. We warn caretakers not to wait until they have evidence or proof of the problem to address it, because by that time, these kids are so far gone that we can’t get them back.