DRUG-FIGHTERS TURN TO RISING TIDE OF PRESCRIPTION ABUSE

Washington - After years in which marijuana, cocaine and heroin were
by far the main focus of the nation's war on drugs, the Bush
administration is now attacking the rising abuse of prescription drugs.

While marijuana remains the nation's most abused drug, according to
government and private studies, narcotic pain relievers like OxyContin
and Vicodin, along with a variety of some other prescription
medications, have overtaken amphetamines to rank second.

A recent nationwide study by the University of Michigan showed that
from the 2002 to 2003 school year, nonmedical use of prescription
drugs among students in the 8th, 10th and 12th grades increased even
as use of other illicit drugs dropped by 11 percent.

Doctors, other health care providers and law enforcement officials say
prescription drug abuse produces the same problems as street drugs:
addiction, crime and broken families.

And, like street drugs, it produces headlines about celebrity drug
users, notably Rush Limbaugh, who admitted last year that he was
addicted to painkillers. The authorities in Palm Beach County, Fla.,
are investigating Mr. Limbaugh and several of his doctors on suspicion
of "doctor shopping," the practice of contacting a number of
physicians as a way of getting more drugs than are medically
necessary. That activity is a felony in Florida.

One part of the problem is that prescription drugs are advertised to
millions of people every day over the Internet. Many of those drugs
are from foreign sources that state and federal authorities cannot
easily trace, let alone regulate. The House Government Reform
Committee has scheduled a hearing for Thursday on a bill that would
require such Web sites to identify their place of business, as well as
affiliated doctors and pharmacists, and would ban any sales made
without an in-person consultation with a doctor and a valid
prescription.

Beyond Congressional interest, the White House Office of National Drug
Control Policy has for the first time instructed federal agencies with
antidrug programs to develop new strategies to combat prescription
drugs' abuse and illegal marketing.

"We don't want to wait until we get what we had with the crack
epidemic," John P. Walters, who as the office's director serves as the
nation's "drug czar," said in an interview. "Hopefully we're a little
bit earlier in the process."

Mr. Walters's office is largely a bully pulpit for the war on drugs,
setting policy and then lobbying Congress for money that is
distributed to the agencies carrying out the efforts. As a measure of
the administration's concern about prescription drugs, President Bush
is seeking $12.6 billion for antidrug programs next year. That would
be a 4.6 percent increase, a request nine times as high as the average
increase proposed for programs that do not involve defense or national
security.

Much of the responsibility for the new focus on prescription drugs
falls on the Food and Drug Administration and the Drug Enforcement
Administration. Mr. Walters said the F.D.A. was being instructed to
improve labeling of commonly abused drugs and to provide doctors more
information about the medicines they prescribe. The D.E.A. has been
asked to shut down online pharmacies selling drugs without
prescriptions and to discourage credit card companies from
facilitating sales.

Some drug experts say the effort, while impressive, comes late.

"I'm not a big subscriber to the fact that prescription drug abuse is
new," said John Burke, a former Cincinnati police officer who now
leads a regional antidrug task force in southern Ohio. "It's always
been there. There has been some increase, but it's just getting more
attention because of certain drugs, like OxyContin obviously."

Mark Kleiman, a professor of public policy at U.C.L.A., said the
widespread abuse of prescription painkillers began nearly a decade
ago.

"It would have been great if people looking at those numbers had
started to move in the mid-1990's," Professor Kleiman said. "That's
not to say it's bad to do something now. We still have a major drug
problem here that hasn't been addressed in any serious way."

Since arriving on the market in 1996, OxyContin has become one of the
most commonly prescribed narcotics for treating pain, notable for a
time-release delivery and an active ingredient that is twice as potent
as morphine. Abusers crush the tablets to gain its full impact at once
through snorting or injection. The effect is a euphoria that many drug
experts say is equal to that produced by heroin.

Rural areas and other regions where many are employed in physical
labor have been hit especially hard by the growing popularity of
OxyContin and other painkillers. Louise Howell, executive director of
Kentucky River Community Care, a social services agency in the state's
Appalachian region, said easy access to prescription drugs through
doctor shopping and Internet sales had brought enormously painful
consequences.

Citing cases in which users were supporting their habits by selling
their homes and stealing from their families, she said: "It's
overwhelming us. We're imploding, and it's shameful."

Sgt. Bill Purcell of the Virginia state police reports the same
problems in southwest Virginia, where he supervises a regional drug
task force. In the last five years, he said, there have been "dramatic
increases" in illicit use of prescription drugs, a trend characterized
by the theft of doctors' prescription pads, callers to pharmacies who
pretend to be physicians, and nurses who call in prescriptions for
themselves.

"These drugs are everywhere," Sergeant Purcell said.

Mr. Walters, the White House antidrug official, said his office
intended to press more states to adopt computerized monitoring
programs that help reduce doctor shopping by tracking the identities
of those who write prescriptions and those who receive them; fewer
than half the states now have such programs.

And Michael Horn, director of the National Drug Intelligence Center, a
Justice Department agency that provides analysis for policy makers and
support for drug-fighting programs, said he planned to shift more
resources into generating information on prescription drug abuse.

"The increasing rates we've seen," Mr. Horn said, "are kind of
scary."

But even the proposed level of federal spending may not make much
difference, state and local law enforcement officers say.

"Even the D.E.A. people I talk to say they are hurting for resources,"
said Sergeant Purcell. "Unless we get more resources, we'll always be
behind the eight ball."