War on drugs moves to pharmacy from jungle

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(Reuters) - Pamela Storozuk, a petite 59-year-old, spent most of her career as a sales representative, dragging heavy suitcases filled with presentation materials. When her husband developed prostate cancer, she cared for him, often helping to lift him out of the bath or into bed.

Eventually, the strain on her back caught up with her. Today she has five herniated discs and relies on painkillers to function.

Over the past six months, however, the Fort Lauderdale, Florida, resident has found it increasingly difficult to get her medications. Her regular pharmacy is often out of stock, and others refuse to dispense painkillers to new patients.

"They look at you like you're an addict, a lowlife," she said.

Storozuk is one of thousands of Americans caught up in the government's latest front in the war on drugs: prescription painkillers. From 1999 to 2009, the number of deaths from narcotic pain pills nearly quadrupled to 15,597, more than those from heroin and cocaine combined, according to the latest figures from the U.S. Centers for Disease Control and Prevention.

In response, the U.S. Drug Enforcement Administration has beefed up its efforts to block the diversion of prescription drugs to the black market, using many of the techniques it employs to combat illegal drug use: wire taps, undercover operations and informants.

Such efforts have helped it dismantle hundreds of "pill mills" - sham pain clinics that write thousands of prescriptions with few questions asked - as well as dozens of rogue Internet pharmacies.

Now the agency is using the same tactics to prosecute the legitimate pharmaceutical supply chain, which is required to maintain certain record-keeping and security protocols to prevent drug diversion.

Over the past three years, the DEA has stepped up its inspections and levied millions of dollars in fines against drug wholesalers for what it said were breaches of those rules.

In February, the DEA suspended the license of drug wholesaler Cardinal Health Inc to sell narcotic painkillers and other controlled substances from its center in Lakeland, Florida, saying it had failed to detect suspicious order volume from several pharmacy customers. Under a settlement, Cardinal has agreed not to ship controlled substances from the facility for two years.

Shortly afterward, the agency raided two CVS pharmacies and issued inspection warrants at a half-dozen Walgreen Co drugstores and a Walgreen distribution center.

NOT THE MEDELLIN CARTEL

"The techniques that law enforcement uses to combat drug traffickers, whether they're Colombian organizations or Mexican cartels or Afghan drug lords, those techniques are very, very essential in combating prescription drug abuse," DEA Administrator Michele Leonhart said in an interview.

But critics say applying the same strategy to the legitimate supply chain as to Colombian drug lords is ineffective and is also causing supply shortages that hurt pain patients.

"Going after a pharmaceutical manufacturer is not like going after the Medellin cartel," said Adam Fein, president of Pembroke Consulting, which advises pharmaceutical manufacturers. "I don't believe it is appropriate for the DEA to shrink the supply of prescription drugs, because it has unanticipated effects that have nothing to do with the problem."

Florida has long been considered the epicenter of painkiller abuse, due to the spread of pill mills. But experts say those are only a small part of the problem.

"The majority of drugs that end up in the illicit trade come from otherwise well-meaning physicians who do not understand the consequences of their prescribing habits," said former DEA agent Robert Stutman, whose Stutman Group management consulting firm designs substance abuse prevention programs.

Between 1991 and 2010, prescriptions for narcotic painkillers rose to 209.5 million from 75.5 million, according to National Institute on Drug Abuse.

Leonhart said that physicians, however, "now understand the problem."