MIAMI (AP) -- The White House drug czar wants doctors, states and law enforcement working harder to stop America's deadliest drug-abuse problem: highly addictive prescription painkillers. They are killing more people than heroin and cocaine combined as they foster a slew of illegal "pill mill" clinics centered in Florida.
The federal government on Tuesday announced its first-ever comprehensive strategy to combat the abuse of oxycodone and other opioids, aiming to cut misuse by 15 percent in five years. That goal may sound modest, but it would represent a dramatic turnaround: Emergency room visits from prescription drug overdoses doubled from 2004 to 2009, when they topped 1.2 million, according to federal health officials.
"To say we are going to do away with the problem in five years, we cannot do that," said Dr. Roland Gray, medical director of the Nashville-based Tennessee Medical Foundation and a Food and Drug Administration adviser on addiction issues. "I think they are headed in the right direction."
The new approach will depend on education, stepped-up law enforcement and pill-tracking databases, with particular emphasis on Florida, where 85 percent of all oxycodone pills in the nation are prescribed. Many of those end up along the East Coast and in Appalachia, where people take buses to Florida just to get pills in phenomenon dubbed the "OxyContin Express."
"The key is that everyone realizes there is no magic answer to this," Gil Kerlikowske, President Barack Obama's national drug policy director, said in an interview with The Associated Press. "It's a really complex problem."
Danny Webb, the sheriff of Kentucky's rural Letcher County, said he would welcome a 15 percent drop in misuse of prescription drugs.
"Anything would help, because we're drowning in it up here in eastern Kentucky," Webb said, adding that he is skeptical any government plan will ultimately work. "I don't know if there's ever going to be a winning to this war on drugs."
When used properly, oxycodone and similar medications help people deal with chronic pain by slowly releasing key ingredients over many hours. Abusers crush the pills and sniff or inject them, resulting in a euphoric heroin-like high.
According to the federal Centers for Disease Control and Prevention, overdose deaths from painkillers have risen from less than 4,000 in 2000 to more than 11,000 in 2007, the most recent statistics available. Cocaine deaths went from about 3,000 in 2000 to more than 5,000 in 2007; for heroin, the numbers have remained steady at around 2,000 each year.
The agency also reported last year that drug-induced deaths, led by these painkiller drugs, are now second only to car crashes in accidental fatalities nationwide.
Renee Doyle, a Fort Lauderdale mother whose son Blayne was in an oxycodone haze when he was struck and killed by a car in 2009, said he was able to get 240 pills on each monthly visit to a local pain clinic by doing little more than asking for them.
"I think people were just not paying attention and then greed took over," she said. "They are legal drug dealers and they should be outlawed."
There are plenty of legitimate pain clinics. Those that cross the line dispense hundreds of pills per patient based on questionable diagnoses - or none at all. They often accept only cash and direct people to get prescriptions filled at specific pharmacies sometimes owned by the same operators.
Although the DEA and local police recently arrested more than 20 people, including five doctors, in a crackdown on South Florida pill mills, Kerlikowske said it's not strictly a law enforcement issue.
"It's a real collaboration. It's not just a prosecutor and DEA. It isn't just the medical profession. It's everybody," he said.
The strategy announced by Kerlikowske's office calls for additional training on responsible prescription practices for the more than 1 million doctors authorized to prescribe certain controlled substances. Such a change would require congressional approval.
"There has been a flood of new medicines and many of the physicians out there weren't trained in using them, so there's a big gap in understanding how to manage these drugs," said Dr. Janet Woodcock, who directs the agency's Center for Drug Evaluation and Research.
Another element of the strategy is a national education campaign featuring ads like the famous frying-egg "this is your brain on drugs" ad used in past anti-drug efforts. Key to that is making sure parents keep prescription drugs out of the hands of their children, who are now abusing them more than any illegal drug except marijuana. Drug companies will be asked to contribute money to the effort.
The plan also calls for continued aggressive law enforcement efforts and better training, as well as modest increases of $123 million for drug prevention and $99 million more for treatment programs.
In Florida, Miami DEA chief Mark R. Trouville said he expects some physicians to be indicted based on a recent undercover probe