The sale and use of opioid pain medication is on the rise- in the United States- in a country of 311 million, there were 335 million prescriptions written for painkillers in 2011, according to IMS Health.
Opioids are highly addictive, and numerous risks are present from their use- they can severely depress respiration, and when mixed with alcohol or other drugs can be deadly. In 2008, 14, 800 Americans died from opioid overdose- more than that from heroin and cocaine.
The huge amount of opioid prescriptions reflects the lack of a clear and central regulatory body to determine their distribution. Although the Drug Enforcement Association (DEA) is the primary body, the prescription and administration of these drugs is conducted and regulated on a state-by-state basis. Many states continue to lack the infrastructure to monitor the prescription of drugs across the state, known as a prescription-monitoring program (PMP). In 2008 15 states were lacking a program like this, although now 48 have legislation in place allowing for PMPs, and 41 have gone so far as to set up a database.
States like Florida, lacking a PMP until 2011, was often ridiculed as ‘Oxy express,’ after the well know painkiller Oxycodone. This was the ideal unregulated ground for enterprising individuals such as Christopher and Jeffrey George to easily establish and expand pain clinics that administered both the prescriptions for the medication from a licensed medical practitioner and distributed the drugs that swiftly became the largest in the country.
Ordering generic opioids from a wholesaler was very simple: all the George brothers had to do was fax the credentials of a doctor, along with an order form. By ordering small amounts from many providers, the George brothers were able to remain under the radar of regulatory bodies, and rake in incredible profits.
Pill mills like that of the George brothers are incredibly lucrative- their two-year run they sold 20 million oxycodone pills and made $40 million. One element that helped the George brothers make enormous profits was the lack of discrimination over which visitors to their clinics would be awarded prescriptions- back pain, fibromyalgia, divorce or anxiety were all considered valid reasons. Doctors working for them could stand to make up to 1.9$ million a year.
Although the George brothers operation was shut down in 2011, and both brothers and some associates are currently serving terms in jail, this remains an incredibly small advance in the regulation of these drugs. The sale of prescription pain medication is a remarkably lucrative enterprise- in 2011, U.S. sales of prescription painkillers amounted to $9 billion, according to IMS Health.
Prescription painkillers such as Oxycodone are swiftly becoming one of the most frequently abused drugs in the world. Despite, or perhaps because of this, the legal production of these drugs is going up- the DEA has allowed for the production of 98 million grams of oxycodone in the U.S. in 2012, an increase of 40% since 2008. The continued lack of adequate regulation of their distribution, and the excessive prescription of these painkillers will ensure that although some checks have been put into place, the abuse of painkillers is on the rise.