Prescription drugs: time for large doses of attitude change

diversionHandThe recent death of singer Whitney Houston is another unwelcome reminder that America is a vast emporium of addictive prescription drugs.

Several news reports say prescription sedatives may have been involved. Americans soon may be deluged by more well-meaning quotes from experts that Houston’s death is a “wakeup call” for us to turn the corner on rampant dispensing addictive prescription narcotics.

We went through similar news cycles with the drug-impelled deaths of Michael Jackson, Heath Ledger, Anna Nicole Smith, John Belushi and a parade other stars who died from toxic drug cocktails.

We risk becoming desensitized to celebrity deaths instead of alarmed by them. In the process, we risk becoming desensitized to prescription-drug abuse as the addictive epidemic that it is. And so much of this epidemic is financed by insurance money that pays for the illicit prescriptions.

Solving our problems by gulping painkillers and sedatives isn’t new, but the levels to which we’re taking quick fixes should be alarming. The Centers for Disease Control tells us this much:

  • Opiod painkillers cause more overdose deaths in the U.S. than heroin and cocaine combined.
  • By 2010, enough addictive painkillers were sold to medicate every American adult with a typical 5 mg dose of hydrocodone every four hours for one month.
  • Three percent of physicians accounted for 62 percent of opioid painkillers in one study.
  • Drug deaths outnumber traffic fatalities for the first time in 30 years, fueled by a rise in abuse of addictive prescription drugs, notes a Los Angeles Times analysis of CDC data.

Shady doctors and pharmacies are more than glad to provide the fixes, for a fee. The profits for trafficking in prescription painkillers are so large that gangs are creating sham pharmacies whose sole purpose is to process insurer-paid prescriptions for addicts and street dealers.

Whitney Houston’s death is a tragedy, but America’s real drug problem lies with the average person who has the same easy access to painkillers, sedatives and other addictive drugs.

We’re learning from the never-ending cocaine and marijuana wars that we can keep wiping out cartels in South and Central America, but more cartels will take their place as long as stateside demand makes the immense profits worth the perceived risk.

This says something about our domestic war with prescription-drug trafficking. Yes, we must work to choke off the suppliers — sleazy pain docs, dishonest pharmacies and the like. But others will take their place.

So we must also attack the epidemic at the source: Users. This  means consumer addicts, drug-buying pain patients, school kids and others. This means massively stepped-up education campaigns about the risks of overuse and consequences that can follow.

Education is a shared responsibility, especially among those with the resources to pull it off. This means the insurance and medical establishments, the business community and other stakeholders.

So when it comes to narcotic prescription drugs, maybe consumers need large doses after all: Doses of awareness and attitude change.

The author is director of communications for the Coalition Against Insurance Fraud. 

No such thing as legislative “no-brainer”

ideaBrainAs someone who has been involved in legislative affairs for most of my adult life, I cringe when I hear someone describe a legislative issue as a “no-brainer.” I’ve learned the hard way that “no-brainers” are as difficult to get enacted into law as the most controversial issues.

A couple of prime examples:

This year a state is attempting to require mandatory fraud warnings on insurance documents such as policy applications. I expect most insurers in that state already place warnings on claim and application forms anyway. Yet even though insurers support the insurance department’s effort, legislators are moving to stop the effort. Why? Those legislators combine their ignorance in understanding insurance fraud issues with their free-market philosophy. They do not want government telling business what to do, even if the business supports the effort.

Fraud warnings help fight insurance fraud — they give consumers a clear message that committing fraud is a crime. The warnings also help prosecutors prove that suspects had intent to commit fraud when they signed a document clearly warning them about the crime. And, who benefits from the warnings? Everyone benefits, because if we can reduce the cost insurers pay for fraud we’ll help reduce the premiums that consumers pay.

But, this is not the only case.

Several years ago a former governor of a Western state vetoed a bill creating a fraud unit, stating that the unit would add to personnel to the state. He opposed adding employee costs, and assessing insurers to fund the unit would constitute an additional tax. He found the assessment undesirable even though insurers were more than happy to pay for the fraud unit, without any new tax dollars. It took an additional year to get that governor to understand this, and he finally signed the identical bill. Adding state personnel and a “tax” was wrong in one year, but the next year, it was okay.

We have seen this in other states, where trying to increase the assessment on insurers, which insurers supported to help the state’s anti-fraud effort, was opposed by legislators who saw it as a tax increase. And by golly, no business should pay extra “taxes” even though that business supported the effort.

And then in some states the assessment was increased to bring more investigators on board, but state hiring freezes stopped the hiring even though funds existed to pay for those investigators.

“No-brainers” don’t exist in the legislative arena. And fraud fighters need to stay on top of all fraud bills that as they work to strengthen state anti-fraud efforts.


The author is director of government affairs for the Coalition Against Insurance Fraud and has served in that position since 1993.

Innovative ordinance in Florida revisited

HillsboroughLast fall, local legislators in Hillsborough County, Fla., took a radical step and passed restrictions on medical clinics that treat auto-accident victims in that jurisdiction. Lawmakers and residents were growing tired of hearing that the Tampa area had become the new staged-crash capitol of the U.S.

The county had hoped the state would enact new restrictions to crack down on clinics. But when state legislative efforts failed, the county imposed its own crackdown. The new ordinance requires doctors affiliated with local clinics to be onsite at least three days a week. This prevents clinics from using no-show docs just to look legit.

Doctors who operate clinics also must be a signatory to the clinics’ bank accounts and insurance policies — another good measure that can trip up a sham clinics.

Many observers believe the new ordinance is an effective step to put shady clinics out of business.

But now comes word that county legislators are reworking the law in the face of a lawsuit by five clinics. The clinics say the new law unfairly punishes legitimate clinics with stringent, unnecessary regulations.

So legislators are meeting today to amend the law to try to appease legitimate clinics while retaining enough teeth to hurt the crooked ones. We wish them success.