According to the Office of National Drug Control Policy and the most recent survey of drug use among young people – prescription drugs are the second-most abused category of drugs after marijuana.

In addition, the latest National Survey on Drug Use and Health shows that over 70 percent of people who abused prescription pain relievers got them from friends or relatives, while approximately 5 percent got them from a drug dealer or over the Internet.

“Opiate overdoses, once almost always due to heroin use, are now increasingly due to abuse of prescription painkillers. In our military, illicit drug use increased from 5% to 12% among active duty service members from 2005 to 2008, primarily due to non-medical use of prescription drugs,” explains Robert Saenz, a nationally recognized expert in the area of drug Misuse, Addiction and Diversion, otherwise known as M.A.D. Mr. Saenz manages, coaches and advises physicians across the country on the very necessary elements of safeguarding medical practices from M.A.D. situations.

He is a graduate of both the US Border Patrol Academy and the FBI National Academy and spent more than 20 years investigating federal crimes with the Department of Justice, and was recently tapped to write legislation for the State of Oklahoma on the subject of drug diversion.

Hawaii’s Electronic Prescription Accountability System, established in 1943 and overseen by the Department of Public Safety, monitors Schedule II, III, and IV controlled substances dispensed by physicians, pharmacies, and law enforcement. With recent enacted legislation, the program can now allow sharing of prescription data with other states that have government-authorized prescription monitoring programs.

”Where the historical attitude toward prescription opioids was the doctor prescribed and then the patient was responsible for the use of the prescription, that has changed. Now, doctors can be held just as liable for what happens with the medications they prescribe,” explains Saenz.

Just look at the statistics. Between 2004 and 2008, the estimated number of ER visits that involved non-medical use of ‘narcotic’ pain relievers increased 111%. (SAMHSA -Results from the 2009 National Survey on Drug se and Health, Nat’l Findings 2010.)

So what are doctors to do? Mr. Saenz believes there is plenty of room to both help patients while avoiding the potential for prescription drug abuse. “By implementing a functional based treatment plan, where compliance auditors carefully review treatment plans which include functional goals alongside the medical professional, the risk for medical practices when it comes to drug diversion pitfalls can be avoided successfully without a reduction in quality of care.”

High risk patients must be identified, such as when a patient has a history of opioid dependance. ‘Oklahoma is one of the first states to implement a statewide database that keeps track of prescription history so if there is a question about a particular patient’s propensity toward drug-seeking behavior, it can be included or ruled out as a factor in a higher risk scenario.’

Robert Saenz will be speaking to the Hawaii Pain Society Meeting January 18-19th. Mr. Saenz served 20 years with the federal government as a law enforcement agent with the Department of Justice and as a Director of International Affairs with the United States House of Representatives. He is currently the President of a national health care consulting firm which manages and advices medical and pain management practices.

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