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Taking on the social cost of prescription drug abuse

DADE CITY

Circuit Judge Lynn Tepper has heard about children being harnessed to door handles so they don't wander off.

Child protection workers walking into homes so thick with human waste they have to go outside and vomit.

Four-year-olds "taking care" of their younger siblings.

The common thread: The parents have an addiction to prescription pills.

"What happens is, they're so drugged up they never do anything for the home," the judge said. "They're so busy doing drugs, they don't clean."

Tepper was talking last week with state Rep. John Legg, R-New Port Richey, whom she invited to observe in her courtroom for a day. Legg says he has been focusing on the criminal side of the problem, namely through legislation that cracks down on doctors who hand out prescriptions by the handful.

"We haven't even begun to look at the social aspect," Legg said.

That's Tepper's territory. She hears cases of domestic violence and parents who have lost custody of their children. More than half, she says, have an element of pill abuse.

"Have you seen this grow in the last few years?" Legg asked her.

"Leaps and bounds," she replied.

Growing like an epidemic

The problem — an epidemic, authorities are calling it — has many claws. Addicts go doctor shopping, persuading more than one doctor to load them up with pills. At some pain clinics, doctors write prescriptions without thoroughly examining patients. People photocopy prescriptions, sell pills on the street, rob pharmacies.

The drugs range from narcotic pain killers like hydrocodone and oxycodone, to anti-anxiety medications like alprazolam.

They work by targeting the brain's chemistry.

Taken in excess, they turn patients into zombies. And for their children, Tepper said, "it's worse than being raised by wolves."

So for one day, the judge wanted Legg to see some first-hand, human examples of the destruction.

In court that morning, among the parade of dependency cases was a woman trying to regain custody of her 15-year-old son. The boy had a history of sexual abuse, the father was in prison and the mother had just had another child — her fifth — a week earlier.

Amid all that drama, the mother disclosed her medications: Xanax, hydrocodone and oxycodone, several times a day, every day — all prescribed by a doctor.

The mom said she takes the medications for scoliosis and other back problems.

"You believe that you're able to care for your children while taking these medications?" Tepper asked her.

"I'm not intoxicated," the woman replied. "I can care for my children."

The judge noted the woman, who has not visited her son or otherwise complied with her court-ordered case plan, was having trouble keeping her eyes open.

Hard problem hurts helpless

In an interview later, Tepper said the pill problem is worse than any drug crisis she has seen before.

One reason: accessibility.

"It's legitimized in the public. All you need is a doctor," she said. Pills are also easy and cheap to buy on the street.

The addiction is tougher to overcome and it kills faster, she said.

"We don't have elderly people addicted to pain pills. They don't live that long," she said.

As a dependency court judge, Tepper has to make decisions in the best interest of the children involved. That means imposing conditions on the parents to keep them on track. Drug tests. Parenting classes. Visitation schedules.

But it's no longer as simple as someone testing positive for cocaine, for example.

"We have to rethink whether you give them a bye for having a prescription. And that's a philosophical question," she said.

She'd like to see a laundry list of policy changes — for starters, with Medicaid reimbursements that now have taxpayers footing the bill for the pills and doctors that, in some cases, are the root of the problem. She thinks the medical and pharmaceutical professions need better policing in this area.

In the meantime, she has to figure out how to help the most helpless victims.

"We have children that will now be a burden on the system for their lifetime," she said, noting the array of developmental problems she is seeing among pill addicts' neglected kids.

Steps being taken

The problem is only beginning to be addressed.

The Pasco County Commission recently imposed a moratorium on new pain clinics. At the state level, lawmakers have created a database requiring pharmacists and doctors who dispense drugs to report within 15 days information on anyone who has a prescription filled for the drugs at issue.

Doctors will then be able to see if the patient asking for pain pills recently got a month's worth down the street.

But they aren't required to look; participation is strictly voluntary. And because of a lack of funding, the database has yet to go online.

For his part, Legg says he plans to introduce legislation next year that imposes civil liabilities on doctors who prescribe the medications recklessly.

"They've got to feel some punitive damages for the lives they're destroying," he said. "It's not just the patients' lives they're destroying. It's the kids' lives. That's what I really got today."

Molly Moorhead can be reached at moorhead@sptimes.com or (727) 869-6245.

Taking on the social cost of prescription drug abuse 10/16/10 [Last modified: Saturday, October 16, 2010 2:03pm]
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