U.S. TARGETS PRESCRIPTION DRUG ABUSE

Closer Monitoring of Painkillers Sought

WASHINGTON - The Bush administration announced an expanded crackdown
yesterday on what it called the growing menace of prescription drug
abuse, which is said to touch and harm more than 6 million Americans a
year.

Top administration officials said the initiative, the first
comprehensive one of its kind, would increase state monitoring
programs that detect suspicious prescriptions and patients suspected
of doctor shopping. It also would increase education to doctors about
how to detect potential prescription drug abusers. In addition, it
will take on the burgeoning use of the Internet to purchase controlled
drugs.

Karen Tandy, the head of the Drug Enforcement Administration, said
thousands of Web sites regularly offer narcotic medications, often
without a prescription or a doctor visit. Ms. Tandy said it has been
difficult to move against them because they closed as soon as they are
identified and then reopen under another name.

"The nonmedical use of prescription. drugs has become an increasingly
widespread and serious problem in this country," said John Walters,
director of the White House Office of National Drug Control Policy.
"The federal government is embarking on a comprehensive effort to
ensure that potentially addictive medications are dispensed and used
safety and effectively. "

Mr. Walters said President Bush's proposed 2005 budget would increase
funds to attack illicit prescription-drug use by $20 million, to $138
million. Most of the money would be directed at reducing the abuse of
opium and morphine-based painkillers, which are. among the most widely
prescribed medications in the nation.

The issue of how painkillers such as OxyContin, Lortab, and Vicodin
are prescribed and used has become a touchy one, and some pain doctors
and law enforcement officials disagree over how widely and readily
they should be available.

The Drug Enforcement Administration and Justice Department have become
more aggressive in targeting and prosecuting doctors and pharmacists
who they say. are improperly prescribing and distributing prescription
narcotics, and a dozen health practitioners have been charged recently
for their prescribing practices. Several are in prison.

But doctors and some patient advocates say the government has created
a "chilling effect" that keeps many doctors from prescribing
painkillers that patients need. They argue that the more pressing
problem is that so many patients in pain are not getting them.