Doug Ross

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• Doug Ross
• NDIC Field Program Specialist
• October 13, 2005

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The National Drug Intelligence Center
Johnstown, PA
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NDICs Mission

• Support national policy and law enforcement
  decision makers with strategic domestic drug
  intelligence
• Support the Intelligence Communitys counterdrug
  efforts
• Produce National, Regional, and State Drug Threat
  Assessments

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NDIC Products
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Prescription Drug Abuse Update
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http//www.casacolumbia.org/Absolutenm/articlefile
s/380-final_report.pdf
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Lifetime Abuse of Prescription Drugs by Those
Aged 12 or OlderIn the U.S.
31,768,000
Millions
18,643,000
9,891,000
8,256,000
Source National Survey on Drug Use and Health -
2004
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Lifetime Abuse of Prescription Drugs by Those
Aged 12 or OlderIn the Maine
135,000 (12.1)
86,000 (7.7)
Thousands
41,000 (3.6)
35,000 (3.2)
Source National Survey on Drug Use and Health -
2004
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Past Month of Prescription Drugs by Those Aged
12 or OlderIn the Maine
21,000
Thousands
6,000
5,000
4,000
Source National Survey on Drug Use and Health -
2004
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Maines Most Frequently Diverted Abused
Pharmaceuticals
Source National Drug Threat Survey - 2005
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States Where Pharmaceuticals Contribute Most to
Property Crime
32.4
21.6
21.2
9.9
Nationwide 2.9
10.9
Source National Drug Threat Survey - 2005
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States Where Pharmaceuticals Contribute Most to
Violent Crime
26.8
6.1
7.1
15.1
12.7
Nationwide 2.0
Source National Drug Threat Survey - 2005
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Developments During Past Year in Combating
Pharmaceutical Abuse

• Dec 2004 DEA established a toll-free hotline to
  report illegal prescription drug sales.
• Feb 2005 Ryan Haight Internet Pharmacy Consumer
  Protection Act introduced.
• Aug 2005 NASPER Act passed.

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Benzodiazepine Abuse
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Benzodiazepines

• One in five prescriptions written is for a
  benzodiazepine.
• Benzodiazepines probably will be used at an
  increased level in areas affected by Hurricane
  Katrina.

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How Abusers Use Benzodiazepines

• Often combined with other drugs
• To enhance the effect
• Methadone alprazolam
• Methadone diazepam
• Heroin clonazepam
• Speedballing combining a benzodiazepine with
  a stimulant
• To mitigate the crash from stimulants
• Diazepam used with methamphetamine
• Alprazolam used with methamphetamine

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Lifetime Nonmedical Use of Specific
Benzodiazepines
In Millions
Alprazolam/Lorazepam
Clonazepam
Diazepam
Librium
Source NSDUH - 2004
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Initiates to TranquilizersAll Ages
Numbers in Thousands
Source National Survey on Drug Use and Health -
2004
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Characteristics of Primary Tranquilizer
Admissions 2002

• Between 1992 and 2002 primary tranquilizer
  admissions increased 79 (from 4,600 in 1992 to
  8,300 in 2002).
• Demographic characteristics
• More likely to be female than all other
  admissions (50 vs. 30)
• More likely to be Caucasian
• For other tranquilizer admissions, the primary
  drug was most often opiates (46) followed by
  alcohol (30).

Source The Dasis Report, 22 July 2005
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Characteristics of Primary Tranquilizer
Admissions - 2002
Regional Use
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The Chilling Effect
PERCEPTION DEA is persecuting innocent
doctors who are only trying to adequately
treat patients who are in pain. REALITY DEA
is only prosecuting those doctors who are
endangering their patients and the public by
operating outside the bounds of accepted
medical practice.
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The Chilling EffectDoctors Who Engage in the
Diversion of Pharmaceuticals
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The Chilling EffectDEA Actions Against Doctors
Total Number of DEA Doctor Registrants
879,011 Number of DEA Actions Taken 765
(0.09)
Total Number of DEA Doctor Registrants
897,953 Number of DEA Actions Taken 783
(0.09)
Total Number of DEA Doctor Registrants
923,829 Number of DEA Actions Taken 698
(0.08)
Total Number of DEA Doctor Registrants
939,363 Number of DEA Actions Taken 568
(0.06)
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The Chilling EffectActions You Can Take If
Still Concerned

• Obtain education about prescribing controlled
  drugs.
• Learn how to recognize addictive behavior and
  signs of drug diversion.
• Work with local pharmacists.
• Develop a rapport with law enforcementconsider
  joining NADDI.

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Conclusion

• Pharmaceutical abuse poses a serious drug threat
  to Maine and the rest of the country.
• The lifetime rate of abuse for several
  benzodiazepines decreased in 2004.
• Initiates to tranquilizers decreased in 2001, but
  began to increase again in 2002.
• The chilling effect should not be a concern to
  doctors operating within the bounds of accepted
  medical practice.

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National Drug Intelligence Center POCs

• Doug Ross
• Field Program Specialist
• Phone [phone]
• Email Douglas.Ross_at_usdoj.gov
• Maine State Analyst David Pavlik
• Phone [phone]
• Email David.A.Pavlik_at_usdoj.gov

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Young People Who First Used Tranquilizers
Nonmedically
Numbers in Thousands
12 17 Year Olds
18 25 Year Olds
Source National Survey on Drug Use and Health -
2003