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73–212 PDF 2012

PRESCRIPTION DRUG ABUSE EPIDEMIC 

IN AMERICA 

HEARING 

BEFORE THE

SUBCOMMITTEE ON CRIME, TERRORISM, 

AND HOMELAND SECURITY 

OF THE

COMMITTEE ON THE JUDICIARY 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED TWELFTH CONGRESS 

SECOND SESSION 

MARCH 7, 2012 

Serial No. 112–95 

Printed for the use of the Committee on the Judiciary 

( 

Available via the World Wide Web: http://judiciary.house.gov 

(II) 

COMMITTEE ON THE JUDICIARY 

LAMAR SMITH, Texas, Chairman 

F. JAMES SENSENBRENNER, JR., 

Wisconsin 

HOWARD COBLE, North Carolina 

ELTON GALLEGLY, California 

BOB GOODLATTE, Virginia 

DANIEL E. LUNGREN, California 

STEVE CHABOT, Ohio 

DARRELL E. ISSA, California 

MIKE PENCE, Indiana 

J. RANDY FORBES, Virginia 

STEVE KING, Iowa 

TRENT FRANKS, Arizona 

LOUIE GOHMERT, Texas 

JIM JORDAN, Ohio 

TED POE, Texas 

JASON CHAFFETZ, Utah 

TIM GRIFFIN, Arkansas 

TOM MARINO, Pennsylvania 

TREY GOWDY, South Carolina 

DENNIS ROSS, Florida 

SANDY ADAMS, Florida 

BEN QUAYLE, Arizona 

MARK AMODEI, Nevada 

JOHN CONYERS, JR., Michigan 

HOWARD L. BERMAN, California 

JERROLD NADLER, New York 

ROBERT C. ‘‘BOBBY’’ SCOTT, Virginia 

MELVIN L. WATT, North Carolina 

ZOE LOFGREN, California 

SHEILA JACKSON LEE, Texas 

MAXINE WATERS, California 

STEVE COHEN, Tennessee 

HENRY C. ‘‘HANK’’ JOHNSON, JR., 

Georgia 

PEDRO R. PIERLUISI, Puerto Rico 

MIKE QUIGLEY, Illinois 

JUDY CHU, California 

TED DEUTCH, Florida 

LINDA T. SA ́ NCHEZ, California 

JARED POLIS, Colorado 

RICHARD HERTLING, Staff Director and Chief Counsel 

PERRY APELBAUM, Minority Staff Director and Chief Counsel 

SUBCOMMITTEE ON CRIME, TERRORISM, AND HOMELAND SECURITY

F. JAMES SENSENBRENNER, JR., Wisconsin, Chairman 

LOUIE GOHMERT, Texas, Vice-Chairman 

BOB GOODLATTE, Virginia 

DANIEL E. LUNGREN, California 

J. RANDY FORBES, Virginia 

TED POE, Texas 

JASON CHAFFETZ, Utah 

TIM GRIFFIN, Arkansas 

TOM MARINO, Pennsylvania 

TREY GOWDY, South Carolina 

SANDY ADAMS, Florida 

MARK AMODEI, Nevada 

ROBERT C. ‘‘BOBBY’’ SCOTT, Virginia 

STEVE COHEN, Tennessee 

HENRY C. ‘‘HANK’’ JOHNSON, JR., 

Georgia 

PEDRO R. PIERLUISI, Puerto Rico 

JUDY CHU, California 

TED DEUTCH, Florida 

SHEILA JACKSON LEE, Texas 

MIKE QUIGLEY, Illinois 

JARED POLIS, Colorado 

CAROLINE LYNCH, Chief Counsel 

BOBBY VASSAR, Minority Counsel 

(III) 

C O N T E N T S 

MARCH 7, 2012 

Page 

OPENING STATEMENTS 

The Honorable F. James Sensenbrenner, Jr., a Representative in Congress 

from the State of Wisconsin, and Chairman, Subcommittee on Crime, Terrorism, and Homeland Security .......................................................................... 1 

The Honorable Robert C. ‘‘Bobby’’ Scott, a Representative in Congress from 

the State of Virginia, and Ranking Member, Subcommittee on Crime, Terrorism, and Homeland Security .......................................................................... 2 

WITNESSES 

The Honorable Harold Rogers, a Representative in Congress from the State 

of Kentucky 

Oral Testimony ..................................................................................................... 11 

Prepared Statement ............................................................................................. 13 

The Honorable Nick J. Rahall, II, a Representative in Congress from the 

State of West Virginia 

Oral Testimony ..................................................................................................... 18 

Prepared Statement ............................................................................................. 20 

The Honorable Mary Bono Mack, a Representative in Congress from the 

State of California 

Oral Testimony ..................................................................................................... 22 

Prepared Statement ............................................................................................. 24 

The Honorable Stephen F. Lynch, a Representative in Congress from the 

State of Massachusetts 

Oral Testimony ..................................................................................................... 27 

Prepared Statement ............................................................................................. 29 

APPENDIX 

MATERIAL SUBMITTED FOR THE HEARING RECORD

NIH Public Access Study on Opiod Deaths in Rual Virginia ............................... 45 

Prepared Statement of Ameritox, Inc. ................................................................... 65 

Prepared Statement of Anne McGee, Director, Cabell County Substance 

Abuse Prevention Partnership ............................................................................ 68 

Prepared Statement of Greg Puckett, Executive Director, Community Connections, Inc. .............................................................................................................. 70 

Prepared Statement of Timothy Bradley, Captain, West Virginia State Police . 85 

Prepared Statement of Kimberly Becher, MD; and Kane Maiers, MD, Paul 

Ambrose Health Policy Fellows, Marshall University Department of Family 

and Community Health ....................................................................................... 88 

(1) 

PRESCRIPTION DRUG ABUSE EPIDEMIC 

IN AMERICA 

WEDNESDAY, MARCH 7, 2012 

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON CRIME, TERRORISM, AND HOMELAND SECURITY, COMMITTEE ON THE JUDICIARY, Washington, DC. 

The Subcommittee met, pursuant to call, at 10:02 a.m., in room 

2141, Rayburn Office Building, the Honorable F. James Sensenbrenner, Jr., (Chairman of the Subcommittee) presiding. 

Present: Representatives Sensenbrenner, Goodlatte, Marino, 

Gowdy, Adams, Conyers, Scott, and Jackson Lee. 

Staff present: Caroline Lynch, Majority Chief Counsel; Arthur 

Radford Baker and Tony Angeli, Majority Counsel; Ron LeGrand 

and Ashley McDonald, Minority Counsel; Lindsay Hamilton, Clerk; 

and Veronica Eligan. 

Mr. SENSENBRENNER. The Subcommittee on Crime will come to 

order. Without objection, the Chair will be authorized to declare recesses during votes in the House. 

The Chair yields himself 5 minutes, in order to make an opening 

statement. 

Today’s hearing examines the subject of prescription drug abuse 

in America. According to the most recent data from the U.S. Centers for Disease Control and Prevention, legal and illicit drugs 

killed almost 40,000 people nationwide in 2009. Over 100 people 

die from drug overdoses in the United States every day. 

Nearly 3 out of 4 prescription drug overdoses are caused by prescription painkillers, also called opioid pain relievers. Common examples of these painkillers are Vicodin, Percocet, OxyContin, and 

Demerol. 

In 2008, there were nearly 15,000 deaths from prescription painkiller overdoses. For every one of these deaths, there are 10 admissions for drug abuse treatment, and 32 emergency room visits for 

misuse or abuse of prescription drugs. That amounts to over 

475,000 emergency room visits per year, a number which has doubled in just the last 5 years. 

Prescription painkillers work by decreasing the perception of 

pain. These powerful drugs can create feelings of euphoria, cause 

physical dependence, and frequently lead to addiction. Prescription 

painkillers also slow down a person’s breathing. A person abusing 

prescription painkillers might take increasingly larger doses to 

achieve a euphoric effect. These larger doses can cause breathing 

2 

to slow down so much that breathing stops, resulting in a fatal 

overdose. 

Very few prescription drugs involved in overdoses come from 

pharmacy theft. The vast majority come from physicians’ prescriptions obtained by one person and sold or given to another. More 

than 3 out of 4 people who misuse prescription painkillers get their 

drugs from someone else. For the past few years, individuals who 

doctor shop, or seek care from multiple physicians, but fraudulently 

pretend to be in pain, have been a primary source of diverted prescription drugs. 

The law enforcement officials in Florida, once the epicenter of 

prescription drug diversion, have left other States to initiate expensive enforcement programs, as the so-called pill mills migrate 

across the country. 

Prescription drug abuse has been an epidemic for much too long. 

Some of the more notable people who have died from prescription 

drugs include Marilyn Monroe, Bruce Lee, and Elvis Presley. Even 

former Indiana Senator Edward A. Hannegan overdosed on morphine in 1859. In December of 2010, a 13-year-old Utah boy died 

after stealing a bottle of OxyContin from a kitchen counter of a 

friend’s house. He took all the pills in the bottle, except one, and 

died in his sleep. Famous or not, no one is immune from the grip 

of prescription drug overdose. 

This hearing will explore the growing issue of prescription drug 

abuse in our Nation. We have here today four distinguished Members of Congress, who have dedicated their efforts to stop prescription abuse in America. I look forward to hearing about their legislative proposals and other efforts to address a serious national 

challenge. And I would like to thank our witnesses for participating 

in today’s hearing. 

It is now my pleasure to recognize for his opening statement, the 

Ranking Member of the Subcommittee, the gentleman from Virginia, Mr. Scott. 

Mr. SCOTT. Thank you, Mr. Chairman. Mr. Chairman, prescription drug abuse is a serious problem. The number of overdose fatalities has increased dramatically over the recent years. I must 

admit, though, Mr. Chairman, I am puzzled as to the purpose and 

usefulness of today’s hearing. I am used to hearings being an opportunity for witnesses to put forth varying views regarding an 

issue or issues before us, with the opportunity to question such witnesses to gain a keener insight and understanding of the issues. 

We would then have a legislative hearing for further input and 

analysis, including legal analysis, and ensuring that we have constitutional and effective legislation. While I have no doubt that our 

colleagues who are witnesses today will provide helpful information, I anticipate that they will discuss the bills that they have 

sponsored or cosponsored, which makes them advocates for the 

bills, and limits us to one side of the debate on the issues raised 

by those bills. 

Therefore, I trust and also ask that this hearing not serve as the 

only basis for any Judiciary Committee or other consideration of 

legislation that we will hear about, but merely serve as a traditional opportunity we give Members, on occasion, to appear before 

us to present their legislation. 

3 

The bills I anticipate my colleagues will discuss as witnesses include H.R. 1316, 1065, 1925, and 2119. To the extent that they provide additional education, training, and research on safer administration and use of prescription drugs, I am inclined to believe that 

they may contribute to effectively addressing the problem. However, to the extent that they impose congressionally mandated restrictions on access to legitimate medications and business-as-usual 

draconian increases in Federal penalties, I am inclined to believe 

that they will be counterproductive. 

Such approach is not likely to be successful, as our efforts to effectively address elicit drugs. They will lead to over criminalization, 

over federalization, and cause many people the laws purport to protect to end up with unjust and inflexible prison terms, such as the 

mandatory minimums, which one of the bills calls for. 

Mandatory minimums have been proven to be a waste of the taxpayers’ money, and violate common sense, when compared to traditional sentencing. And I would ask unanimous consent, Mr. Chairman, to introduce the Rand study that points this out. 

Mr. SENSENBRENNER. Without objection. 

[The information referred to follows:] 

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Mr. SCOTT. When we think of a pill mill operator dispensing 

death and destruction on a mass scale, we may conclude that no 

punishment is too great, but without definition of what limits the 

application of such person to such circumstances, the, quote, Pill 

mill operator may be a college student in a dorm room, with a 

bunch of pills given to his dorm mates. 

What has proven to work best to address drug abuse, in general, 

including prescription drug abuse are evidence-based solutions 

aimed at preventing drug abuse addiction, injury, and death, rathVerDate Aug 31 2005 10:35 May 08, 2012 Jkt 000000 PO 00000 Frm 00010 Fmt 6633 Sfmt 6601 H:\WORK\CRIME\030712\73212.000 HJUD1 PsN: DOUGA

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er than inflexibly rushing to increased penalties, and restrict legitimate excess to prescriptive drugs. 

We should not continue to take the same approaches, hoping for 

different results. I am not saying that we should not punish lawmakers, but we are already using the criminal justice system as 

much as reductively can be used. We now need to focus on prevention and early intervention. 

There are innovative evidence-based approaches that are not 

likely to be discussed today. One is the use of Naloxone. That is 

a lifesaving medicine used to reverse opiate-based drug overdoses. 

It has been FDA approved since 1971, and is the first line of treatment for paramedics and emergency room physicians who encounter an opiate overdose victim. 

It presents no potential for abuse, because it has no pharmacological effect. It has no effect if it is taken by a person who does 

not have opiates in their system. It takes as little as 2 minutes to 

start working, and provides a 30- to 90-minute window to call for 

medical assistance during a drug overdose. 

Drugs that can be reversed are heroin, OxyContin, methadone, 

Vicontin, and several other drugs. If we are concerned about drug 

overdose deaths, we should be considering this as one of the suggestions. 

The second thing we need to consider, Mr. Chairman, are a 911 

Good Samaritan law. The chance of surviving an overdose like that, 

of surviving a heart attack, depends greatly on how fast one receives medical treatment. Witnesses to heart attacks rarely think 

twice about calling 911, but witnesses to an overdose often hesitate 

to call, or simply don’t make a call, because they fear police involvement. 

People using illegal drugs often fear arrest, even in cases where 

they need professional and medical advice, or assistance for a 

friend or family member. The best way to encourage overdose witnesses to speak up and call 911 is to provide some kind of immunity to those that make such calls. 

Mr. Chairman, such legislation does not protect people from arrest for other offenses, such as outstanding warrants or other 

crimes, but this policy protects only the caller and the overdose victim from arrest and prosecution, simply for calling 911. Several 

State legislatures, including New York, New Mexico, Washington, 

Illinois, and Connecticut have passed 911 Good Samaritan laws, 

and Congress should consider doing the same. 

For the reasons stated above, Mr. Chairman, I agree with my colleagues that prescription drug abuse is an issue about which we 

should be concerned. Anyone who has a friend that is a physician 

or a dentist will recite patients that present with symptoms that 

call for these drugs, and they go doctor to doctor, shopping, and we 

need to do something about those who will actually prescribe to 

those patients. But we should not rush to enact such legislation 

without thorough assessment of the effective options we have before us, and I certainly do not agree that imposing more severe 

mandatory minimums on physicians and pharmacists, who provide 

legitimate medications, would be a good use of our time or efforts. 

Mr. Chairman, I would ask, also, unanimous consent to enter 

into the record a letter to us from the Drug Policy Alliance. 

8 

Mr. SENSENBRENNER. Without objection. 

[The information referred to follows:] 


73212B-1.eps
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Mr. SENSENBRENNER. It is now my pleasure to introduce today’s 

witnesses. 

Hal Rogers has represented the Fifth District of Kentucky since 

1981. He currently serves as Chairman of the House Appropriations Committee, of which he has been a Member for 29 years. He 


73212B-3.eps
11 

received both his bachelor of arts and LLB from the University of 

Kentucky. 

Congressman Nick Rahall has represented the Third District of 

West Virginia since 1976. He currently serves as the Ranking 

Member of the House Transportation and Infrastructure Committee, and received his bachelor of arts from Duke University in 

1971. 

Mary Bono Mack has represented the 45th District of California 

since 1998. Ms. Bono Mack sits on the House Energy and Commerce Committee, and serves as Chairwoman of the Subcommittee 

on Commerce, Manufacturing, and Trade. She received her BFA 

from the University of Southern California in 1984. 

Congressman Stephen Lynch has represented the Ninth District 

of Massachusetts since 2001. He currently sits on the Financial 

Services Committee, and the Committee on Oversight and Government Reform, where he serves as Ranking Member of the Subcommittee on Federal Workforce, U.S. Postal Service, and Labor 

Policy. He received his bachelor of arts degree from Wentworth Institute of Technology and his master in public administration in 

1998, from Harvard. 

Without objection, all of the witnesses’ written statements will be 

entered into the record in their entirety. And I ask that you please 

summarize your testimony in 5 minutes or less. And we will start 

out with Congressman Rogers, since I kind of respect seniority. 

TESTIMONY OF THE HONORABLE HAROLD ROGERS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF KENTUCKY 

Mr. ROGERS. I thank you, Mr. Chairman. Chairman Sensenbrenner, Ranking Member Scott, Mr. Gowdy, and other Members 

of this great Committee, thank you for granting me a few minutes 

to speak on an epidemic that quietly began in rural parts of Kentucky, West Virginia, and Virginia, one doctor at a time, and now 

grips every corner of our great Nation in prolific fashion. As you 

will no doubt hear from the panelists and fellow Members of the 

Congressional Caucus on Prescription Drug Abuse, the statistics 

about this problem speak volumes. 

In 2010, Mr. Chairman, 254 million prescriptions for opioids 

were filled in the U.S. That is enough painkillers to medicate every 

single American adult around the clock for a month. ONDCP has 

identified prescription drugs as the fastest growing drug problem, 

easily eclipsing cocaine and heroin abuse. 

Our military soldiers are coming back from war hooked on these 

pain pills. In the last 2 years, over 150 soldiers have died from 

overdoses. In my home state, we are losing about 82 people a 

month to prescription drug abuse. More than car crashes. Our medicine cabinets are more dangerous than our cars. 

But statistics are just numbers. The four of us on this panel each 

have been touched in a personal way by this tragedy. In some 

counties in my district, Mr. Chairman, 50 percent of all children 

are living in a home without their parents, over half, in large part, 

because of prescription drug abuse. 

I have met with single moms struggling to get through drug 

court, kids living with foster parents, unsure of where their real 

12 

parents are. We have lost mothers, grandfathers, police officers to 

this scourge. My home county sheriff, Sam Catron, community 

leader, personal friend, dedicated public servant, was assassinated, 

because of his pursuit of prescription drug traffickers. A tragic loss. 

My field representative’s nephew, a physician in my district, was 

shot down, senselessly, by a disgruntled drug abuser unable to get 

his fix. 

The most dangerous job in my district? The driver of a delivery 

truck, UPS, FedEx, carrying drugs by mail. I suspect my colleagues 

have similar stories that they would share. This epidemic touches 

big city movie stars and rugged mountain men, and it has to stop. 

We all recognize that this problem will require a coordinated 

multi-pronged approach that incorporates law enforcement, treatment, education, and research. I have worked closely with Congressman Frank Wolf, to stand up a leading grant program in the 

Department of Justice, which supports State-run prescription drug 

monitoring programs. PDMPs monitor the sale and purchases of 

controlled substances, bridging the gap between legitimate medical 

need and potential misuse. 

Since 2002, we have seen the number of States with authorized 

PDMPs triple from 15 to 48. That is a huge accomplishment, but 

our work is nowhere near done. The next challenge will be facilitating the secure interstate exchange of data among these PDMPs, 

so we can eliminate once and for all the doctor shopping which has 

fueled the pill pipeline around our country. 

In the next few weeks, I plan to introduce legislation to support 

the DOJ in opening up lines of communications between States. At 

the appropriate time, I would request that you give this bill, Mr. 

Chairman, your immediate consideration. 

I also helped to establish an organization in my congressional 

district called Operation UNITE, standing for Unlawful Narcotics, 

Investigations, Treatment, Education. It is a bright star in our 

charge to empower our youth and create an anti-drug culture, and 

knock out abuse for good. So far, on the law enforcement side of 

that organization, it covers some 42 counties. Those undercover 

agents, some 30 of them, have sent to the prison around 4,000 

pushers, in just my district. 

UNITE, with its focus on investigations, treatment, and education, is a fantastic model, ripe for replication around the country. 

Operation UNITE is the lead sponsor for the national RX drug 

summit later this spring in Florida. 

Collectively, Ms. Bono Mack, Mr. Rahall, Mr. Lynch, and others 

have introduced a number of bills focused on law enforcement, prescriber education, and research that would help to curb the rising 

tide of abuse. Many of them have been referred to this Subcommittee. 

While I appreciate the opportunity to elevate this issue, which 

continues to plague my people and communities around the country, I would much rather see your Subcommittee mark up these 

bills, move the ball forward, and take decisive action to end this 

debilitating drug problem. And I stand ready, Mr. Chairman, Members of the Committee, willing and able to assist you in any way 

that you might request. 

[The prepared statement of Mr. Rogers follows:] 

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Rogers-4.eps
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Mr. SENSENBRENNER. Thank you very much, Mr. Rogers. And I 

understand that you have an appropriations meeting to go to. So, 

I think it is best we excuse you. But don’t forget the appropriation 

for our Subcommittee for our Subcommittee, please. [Laughter.] 

Mr. ROGERS. Rest assured, Mr. Chairman. 


Rogers-5.eps
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TESTIMONY OF THE HONORABLE NICK J. RAHALL, II, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF WEST 

VIRGINIA 

Mr. RAHALL. Thank you, Mr. Chairman. I appreciate the opportunity to be before your distinguished Committee today. And while 

I do outrank Mr. Rogers in seniority, I certainly agree with you 

yielding to him first, as the Chairman of the Appropriations Committee, and my dear friend and neighbor from across the river, in 

my district. 

Mr. SENSENBRENNER. Praise will get you a long way, my friend. 

Mr. RAHALL. I appreciate that, Mr. Chairman. And I certainly associate myself with his testimony, and commend him for his efforts 

in organizing UNITE, to which he referred in his testimony. I appreciate the efforts of my colleague from California, Ms. Bono 

Mack, and from Massachusetts, Mr. Lynch. 

This is an issue that crosses all partisan lines, philosophical 

lines, class lines, every line in our society. This issue crosses and 

affects all of us. 

I will be presenting testimony to the Subcommittee on behalf of 

law enforcement officials from my district, healthcare professionals, 

and community leaders. And I am sure this Subcommittee will 

make this testimony public in our continued efforts to educate the 

public and the American people as to this tremendous epidemic 

that faces all of us. 

It was once described as America’s silent epidemic, but it can 

now be openly witnessed any hour, any day, or any night on countless street corners across the country. It is the crippling epidemic 

of prescription drug abuse that we are facing. And every day we 

face new stories and reports of overdoses, deaths, accidents, families torn apart by the vicious cycle of prescription drug abuse. 

Headlines such as this, dealing with addiction in McDonough 

County, in my district. These appear every day in every newspaper. 

And believe you, me, they are touching stories about how these 

communities are trying to deal with this vicious cycle. 

Unlike cocaine or heroin, as Mr. Rogers has said, prescription 

drugs are legal, frequently prescribed by caring physicians, lead by 

the principle oath of ‘‘First, do no harm.’’ Yet, alarming statistics 

show that children and adults are blind to the harmful consequences of these drugs. Even as they become addicted, paying 

upwards of $150 per pill to buy them on the black market. 

Distressingly, my home State of West Virginia has our Nation’s 

highest rate of drug-related deaths. In fact, between 2001 and 

2008, more than 9 out of 10 of those deaths involved prescription 

drugs. And incredibly, as Mr. Rogers has, again, pointed out, drug 

overdoses now kill more West Virginians than car accidents. 

But the alarming use and deaths by prescription drugs is not 

just in West Virginia. As our other distinguished Members will testify, it is across this country. And I could go into the figures, Mr. 

Chairman, but you have those figures as well, about what drug 

overdose death rates are in this great country, how they have tripled since 1990, and have never been higher in our Nation’s history. 

I have met numerous times with law enforcement, community organizations, educators, physicians, and many more of my constituVerDate Aug 31 2005 10:35 May 08, 2012 Jkt 000000 PO 00000 Frm 00022 Fmt 6633 Sfmt 6601 H:\WORK\CRIME\030712\73212.000 HJUD1 PsN: DOUGA
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ents. We have had drug summits, and we will continue to have networking processes in which we try to involve all aspects of our community, and to involve those that are personally affected, to get 

them to get to communicate. If they don’t want to openly, at least 

at these networking seminars, with those law enforcement officials 

with whom, perhaps, they have been afraid to have contact in the 

past, but now find a forum, and find other people in like circumstances as them, and which their fear is no longer preventing 

them from coming forward and telling what is happening on the 

streets, and how they feel the problem can be addressed. 

So, these networks are important. This hearing is vitally important. We must strengthen drug diversion, educate our children and 

adults on prevention, work with the medical community on addiction and pain treatment, and treat and rehabilitate those that are 

affected by this vicious addiction before they succumb to the death 

spiral. 

There are a number of pieces of legislation I and my colleagues 

have joined in cosponsoring. This Subcommittee is certainly aware 

of those. And I leave it in your wisdom to join these bills, perhaps, 

or to pick, as you see as most appropriate, which bills should make 

it to the floor of the House of Representatives. But many bills will 

establish mandatory physician and consumer education, as well as 

authorizing Federal funding to help States create and maintain 

prescription drug monitoring programs that all States can access. 

This is one of the bills that I have introduced. It would set up 

a uniform system for tracking painkiller-related deaths, helping 

States and law enforcement personnel to be able to manage and report data. The West Virginia State Police, our attorneys general, 

and even physicians all consistently stress the need to access a prescription drug monitoring system that is shared between State 

lines and updated in real time. 

So, Mr. Chairman, I urge you and this Subcommittee to consider 

and move forward on legislation that encompasses the provisions 

I have mentioned, and many others. Let us act with dispatch and 

compassion, with an acute understanding of the enormity of the 

challenge before us. 

I conclude by thanking you once again for conducting this hearing, and allowing me and my colleagues to be with you. 

[The prepared statement of Mr. Rahall follows:] 

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Rahall-1.eps
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Mr. SENSENBRENNER. Thank you very much, Mr. Rahall. 

Ms. Bono Mack. 


Rahall-2.eps
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TESTIMONY OF THE HONORABLE MARY BONO MACK, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF CALIFORNIA 

Ms. BONO MACK. Thank you, Mr. Chairman. I am honored to be 

here with my colleagues, as you hold this critically important hearing on the growing and deadly dangers prescription drug abuse 

poses to our Nation. 

One incident last year, in particular, graphically captures the seriousness of this issue. On June 19th, in Medford, New York, a 

man walked into a pharmacy and murdered four people for 11,000 

tablets of Hydrocodone. One of those gunned down was a 33-yearold customer, who was just engaged to be married. Instead, she 

was buried in her wedding dress. A 17-year-old pharmacy employee 

was also killed, and later buried in her prom dress, along with her 

high school diploma. 

This senseless tragedy is just one example of a growing wave of 

drugstore robberies by prescription drug addicts. But it is also part 

of a larger rapidly escalating struggle nationwide against prescription drug abuse and addiction, which is expected to claim the lives 

of nearly 30,000 Americans this year. Just last weekend, I met in 

California with dozens of parents who have lost children to this 

horrible epidemic. 

Two classes of medicines, painkillers, and insomnia and anxiety 

drugs, are responsible for about 70 deaths and nearly 3,000 emergency room visits every day. That is right, a day. And these are 

truly stunning numbers. 

But what is very insidious is the way these powerfully addictive 

narcotic prescription drugs quickly turn people, without any real 

emotional or physical problems into desperate people suddenly facing life-or-death struggles. Few things are more destructive. 

According to the CDC, drug overdose is now the leading cause of 

injury death in the United States, not just in West Virginia, but 

in the United States, in large part due to prescription drug abuse. 

It is not hard to understand why. Today, some 12.5 million Americans regularly abuse prescription drugs, and the problem, as I have 

said, is growing rapidly. There are approximately 7,000 new abusers every day, many of them teenagers and young adults. 

This alarming trend, now a health epidemic, according to CDC, 

is taking a huge toll on society. Today, the abuse of prescription 

drugs, especially painkillers, stimulants, and depressants, is the 

fastest growing drug problem in America. 

As Chairman of the House Subcommittee on Commerce, Manufacturing, and Trade, which has jurisdiction over consumer protection, I have made combating prescription drug abuse a top priority. 

I believe there needs to be a national awakening about the threat 

this alarming epidemic poses to our families and to our communities. Simply put, we are in the midst of an American tragedy. 

What can we do? For starters, we must do a better job of monitoring and limiting access to prescription drugs containing controlled-release oxycodone hydrochloride, including the popular painkiller and killer, OxyContin. 

Originally, OxyContin was intended to be prescribed only for severe pain, as a way to help patients dealing with last-stage cancer 

and other severe illnesses. Today, however, more and more people 

23 

across America are prescribed OxyContin, as well as other generic 

oxycodone drugs for less severe reasons, clinically known as moderate pain, greatly expanding the availability and potential for 

abuse of these powerful addictive narcotics. Someone with a toothache or a sore knee should not be prescribed a potentially addictive 

painkiller. 

Clearly, expanded public education plays a role in addressing the 

problem, but we are not going to make any real progress until we 

limit access to these powerful narcotic drugs, and ensure that only 

patients in severe pain can obtain them. 

We must also improve prescriber education by getting doctors, 

dentists, nurse practitioners, and other prescribers up to speed on 

the dangers of addiction. Today, I have legislation pending in Congress, the Ryan Creedon Act, H.R. 2119, to accomplish this goal. 

The pervasiveness of prescription drug abuse made national 

headlines when Federal, State, and local law enforcement agencies, 

led by the DEA, cracked down on so-called pill mills in Florida, 

where painkillers were routinely dispensed just like M&Ms from a 

gumball machine. 

Congress needs to make it much more difficult for these rogue 

pain clinics to operate, and we should treat offenders like any other 

street drug dealer. By better coordinating the efforts of local, State, 

and national agencies, and by reducing the supply of highly addictive opioid painkillers, I am convinced that we can eventually save 

thousands of lives, and spare millions of American families from 

the heartache of addiction. Mr. Chairman, no child should ever be 

buried in a prom dress again, because we ignored this problem. 

And I just want to say, in closing, that this past weekend, when 

I met with these parents, a number of them spoke about a Dr. Lisa 

Tseng, in Rowland Heights, California, who is being charged for 

three counts of murder for supplying prescription drugs to young 

men, who all overdosed. These parents went and confronted the 

doctor, and she showed absolutely no remorse, whatsoever. And I 

think we should do all we can to ensure she is put away for a very, 

very long time, if she is found guilty. 

So, thank you very much for allowing me to testify today. 

[The prepared statement of Ms. Bono Mack follows:] 

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Mr. SENSENBRENNER. Thank you very much. 

Mr. Lynch. 

TESTIMONY OF THE HONORABLE STEPHEN F. LYNCH, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MASSACHUSETTS 

Mr. LYNCH. Thank you, Mr. Chairman, and Ranking Member 

Scott, for your kindness in allowing us to testify on this important 

issue. 

My colleagues have told the story of drug abuse in America 

today, but I do want to amplify the issue that Ms. Bono was speakVerDate Aug 31 2005 10:35 May 08, 2012 Jkt 000000 PO 00000 Frm 00031 Fmt 6633 Sfmt 6601 H:\WORK\CRIME\030712\73212.000 HJUD1 PsN: DOUGA

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ing about, and that is OxyContin. I will associate myself with the 

remarks of the 3 previous speakers, and rather than take my whole 

5 minutes, I just want to offer a couple thoughts. 

Number one, this OxyContin is so powerful, it is so powerful that 

in a very limited period of time a person who is prescribed this becomes addicted. And we have seen stats now that 99 percent of addicts who are involved with heroin, that are in facilities today in 

the United States, started on OxyContin. And the pattern is that 

they stay on OxyContin until they are financially unable to do so, 

and then they switch over to heroin, which is much, much cheaper. 

But when you allow a company to create a product that is so 

powerfully addictive that in a very short time they create customers for life, that is a very troubling situation. It got so bad in 

my district that I had to create, well, a residential rehab facility, 

first, for boys, and then later for girls, because these kids are getting addicted so young, there is nowhere else to send them. We 

didn’t have any adolescent rehab facilities in my State. So, we had 

to create two. 

We have a situation now where Perdue Pharma lost their exclusivity, and now OxyContin is going to go generic. This is tremendously powerful. And think about this, the profits here are enormous. We are creating a national healthcare system that will allow 

all of these people to continue to financially get the support from 

these pill mills, the drug from these pill mills, having the American 

taxpayer contribute to that. So, this is a very, very dangerous situation. 

And I noticed that on March 1, OxyContin was actually pulled 

from the shelves in Canada. That is according to the Toronto Star 

and the CBC news. I sponsored legislation here in Congress several 

years ago to remove OxyContin from the market. But, let’s face it, 

there are so many drug company lobbyists up here that that bill 

didn’t have a prayer, because the pharmaceutical company lobbyists outnumber Members of Congress probably 7 to 1. 

We have a serious problem here. And I commend you for giving 

us the time here to try to address it. And I commend my colleagues 

for the fights that they are making in their own districts, and now, 

hopefully, we will be able to collectively use our experience to push 

this issue nationally. 

So, I thank you for your time. I appreciate it. And I yield back 

the balance of my time. 

[The prepared statement of Mr. Lynch follows:] 

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Mr. SENSENBRENNER. Thank you, Mr. Lynch. 

I would like to thank all of the Members of Congress who took 

time out of their schedules to come and testify here, as well as the 

Members on the Subcommittee who have come and listened to all 

of these graphic stories. And I am sure that this is just the tip of 

the iceberg. This is a very serious issue. It is one that needs to be 

addressed, and it needs to be addressed in the proper manner. 

Does the gentleman from Virginia have anything else he wants 

to say or to insert into the record? 


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Mr. SCOTT. Yes, Mr. Chairman. Another Rand study showing 

that demand investments work better than supply control. 

Mr. SENSENBRENNER. Without objection, the material is inserted. 

[The information referred to follows:] 


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Mr. CONYERS. Mr. Chairman, can I congratulate you on starting 

our inquiry in this matter with Members of Congress who have 

some great and different experiences about this problem? And I 

thank you for starting it. 


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Mr. SENSENBRENNER. Well, I thank the Chairman emeritus. I am 

always happy to accept congratulations. They mean more from that 

side of the aisle than my own. [Laughter.] 

So, again, thank you very much. And without objection, the Committee stands adjourned. 

[Whereupon, at 10:36 a.m., the Subcommittee was adjourned.] 

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A P P E N D I X 

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Prepared Statement of Anne McGee, Director, 

Cabell County Substance Abuse Prevention Partnership 

My name is Anne McGee and I have been the director of the Cabell County Substance Abuse Prevention Partnership, a coalition of concerned individuals, agencies 

and organizations for the past six years. We are located in my hometown of Huntington, WV which is located on the Ohio River and borders Kentucky and Ohio. 

The single biggest change in my hometown, in my lifetime, has been the devastation 

wrought by the ‘‘drug problem.’’ When the Cabell County Substance Abuse Prevention Partnership was founded in 2006, we thought that crack cocaine being brought 

in from Detroit was the main problem. As we gathered data and studied the problem, we learned that crack may be the drug that garnered the headlines and the 

attention of law enforcement, but far more disturbing and pervasive was the nonmedical use of prescription drugs. Our teenagers were reporting increasing use of 

prescription drugs; the lines at the for profit methadone clinic every morning were 

out the door; drug overdose fatalities were reaching record highs; obstetricians were 

reporting more addicted patients; and reports of drug seekers in the emergency 

rooms were a daily occurrence. 

In 2007, we held a roundtable discussion for healthcare providers to discuss the 

data we had gathered regarding prescription drug abuse. The consensus from those 

in that earliest discussion was that the overprescribing of prescription pain relievers 

and benzodiazepines by the local medical community was a major part of the problem. We followed up with a community wide drug summit where we included all 

sectors of the community. We learned that not only was overprescribing a problem, 

but it was far more complicated: prescription drugs and the selling of those drugs 

by the patient on the black-market was supplementing the incomes of many living 

on fixed incomes; that patients have unrealistic pain expectations and demand and 

expect pain free recuperation from injury or surgery; that the Appalachian culture 

promotes and supports the sharing of prescription drugs among friends and family. 

And that our children were diverting medications prescribed to the adults in their 

lives for both medical and non-medical purposes. Our schools reported that many 

of the expulsion hearings were for students caught bringing prescription drugs to 

school. Local property crime rates were increasing throughout the county and copper 

and other metal thefts were rampant. Then the Journal of American Medical Association published the findings of a CDC study showing WV had the highest death 

rates in the nation for prescription drug overdose. Fatality rates began to skyrocket 

across the nation with WV leading the charge with greatest number of fatalities and 

Cabell County having some of the highest mortality rates in the state. 

As we focused on our youth, we realized there were no evidenced based strategies 

or programs that focused on preventing prescription drug abuse, we also knew from 

community readiness assessments that the community as a whole had little or no 

awareness of the growing prescription drug abuse problem, unless and until it 

struck too close to home. We took the lessons learned in preventing youth use of 

other legal drugs like alcohol and tobacco and we started with general awareness 

strategies combined with attempts to limit youth access to prescription drugs. 

We recruited a few physicians to our cause and they drafted a letter on the coalition’s behalf to every healthcare provider with prescribing privileges in Cabell County, sharing our data and urging and encouraging the use of the WV Board of Pharmacy Controlled Substances Monitoring Database. We conducted awareness presentations throughout the community. We offered trainings to nurses, teachers, coaches, parents and grandparents. We conducted social marketing campaigns and held 

dozens of public forums and summits; and we recruited volunteers and coalition 

members along the way. We have involved the media in every one of our efforts and 

we have seen community readiness increase and a slight decrease in the percentage 

of students reporting the non-medical use of prescription drugs. 

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Knowing that limiting access is a key strategy in reducing youth substance use, 

we have sponsored and promoted prescription take back events collecting over 500 

pounds of unwanted medications in the past year. We have partnered with the local 

hospital to provide information to local senior citizens regarding medication safeguarding and disposal. We have sponsored programs for the local medical society 

and we have talked to every elected official who will listen. 

Prescription drug abuse is destroying southern West Virginia. The statistics and 

data support the severity of the problem. Unlike illegal drugs, prescription drugs 

are subject to regulation and control. Community efforts like the Cabell County Substance Abuse Prevention Partnership can only do so much in reducing the abuse 

and misuse of these substances. We need stronger and better controls over controlled substances. We are losing our children, our work force, and our quality of 

life to an epidemic that is 100% preventable. 

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Prepared Statement of Kimberly Becher, MD; and Kane Maiers, MD, Paul 

Ambrose Health Policy Fellows, Marshall University Department of Family and Community Health 

Drug abuse in Southern West Virginia has an effect on our daily practice of medicine. As family medicine residents we are not only exposed to drug-seeking behavior, 

but see the long term effects of drug abuse in our patient population. Because we 

are new providers in the community, our continuity clinics are targeted by patients 

requesting controlled substances for recreational use. These visits not only take 

away slots in which we could be treating legitimate medical problems, they frustrate 

us as providers. We chose to be family physicians because we have a genuine desire 

to improve the health outcomes of our communities and we sincerely value the physician-patient relationship. We work hard to develop rapport and do not like to disappoint our patients. Despite the level of compassion and professionalism displayed 

as we deny unreasonable requests for pain medication, many visits with drug-seeking patients end with aggression, anger, and occasional threats of violence toward 

the provider. On more than one occasion a patient has revealed a weapon in our 

office. 

Unfortunately, the most difficult of cases involve patients with progressive chronic 

disease that is unable to be properly addressed due to the patient’s fixation on obtaining opiates or benzodiazepines. These patients emotionally drain us as providers. We spend the most time on these visits and make the least progress in decreasing the patient’s morbidity and mortality despite our attempts at intervention. 

This patient population contributes a disproportionate amount to the cost of health 

care in West Virginia. This is not only limited to emergency room visits but also 

to the complications of untreated comorbid conditions that require hospitalization 

for a population that is largely uninsured or receiving Medicaid. The addiction circle 

is not limited to the patients we see in the office. To the unemployed, obtaining a 

thirty-day prescription for oxycodone will more than adequately pay their bills. One 

resident reports admitting at least one patient to the ICU per night who overdosed 

on prescription drugs they were not prescribed. 

We need help combating this epidemic in Southern West Virginia. We need a national controlled substance monitoring program that is real time. Patients routinely 

fill prescriptions in Kentucky and Ohio, but we have also had trouble with more organized patients travelling to pharmacies in Florida. We need educational opportunities that prepare us to properly address prescription drug-seeking behaviors from 

the first day of practice. There is no grace period here. For many of us, our first 

patient encounter was a test of our ability to deny an unwarranted prescription. 

Thank you for championing the development of legislation to curb prescription 

drug abuse. 

Æ