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How An Opioid Treatment Could Be Contributing To The Problem

DAVID GREENE, HOST:

One of the most common treatments for opioid addiction is a drug that's called Suboxone. When used correctly, it can help addicts recover. But it has a dark side. Suboxone is itself an opioid, so it can be abused as well. And some doctors are selling the drug illegally, making the opioid crisis worse. That is the fear in Kentucky, a state that had to confront so-called pill mills where doctors basically handed out prescription drugs on demand. Kentucky's attorney general, Andy Beshear, said he is not taking this new Suboxone issue lightly. He is cracking down.

ANDY BESHEAR: We just indicted a doctor in east Kentucky that was illegally prescribing Suboxone and was taking cash from customers where Medicaid should have covered it. So we have those that are out there that are breaking the law to profit. But the second problem that we have is we do not have sufficient regulations, either in our state or nationally, to assure that only the right patients are getting Suboxone and that they are receiving real counseling. We saw this exact same process happen with the rise of pill mills all over the country.

GREENE: So what's your plan here? How are you going to identify the bad doctors and go after them?

BESHEAR: We have law enforcement investigators right here in our attorney general's office that can and do investigate rogue Suboxone clinics that are not following the current laws that are in the Commonwealth. Now, the second thing we have done is propose legislation very similar to what was passed in West Virginia. Now, that would require that all clinics be at least partially owned by a doctor. So if that doctor loses their medical license, the clinic shuts down - that clinics cannot take cash or cash only, that counseling is required for every single patient that receives a prescription, that sets certain time requirements where we can't see a hundred people come in and out of an office in less than two hours - which, sadly, that we see - and then provide some oversight by our Cabinet for Health and Family Services.

GREENE: But are you worried that this might create some obstacles, some headaches, some unnecessary bureaucracy for doctors who are really doing the right thing?

BESHEAR: Well, what we've seen is that when you put in the right type of regulations, the doctors who are doing it correctly thrive. Right now they are trying to compete with groups that don't have any of the costs that they should have. You know, the right doctors are providing counseling. That costs money to their operations and increase their costs. The road clinics that are operating out of a motel don't have any of that type of overhead. So sadly, the lack of proper regulations has even pushed out a lot of practitioners who want to do this the right way.

GREENE: I'm going to jump to a conclusion here - that you don't have unlimited resources (laughter).

BESHEAR: We do not...

GREENE: Right.

BESHEAR: ...In the Commonwealth, have unlimited resources. But the opioid epidemic, the addiction epidemic, is our single greatest challenge. It's also our single largest impediment to economic growth. I have a mayor from east Kentucky that came to my office that can't get a large retailer to locate there because they don't believe that she can find 135 people in a five-county radius that can pass a drug test for three weeks.

GREENE: Wow. So this is not just about this drug. This is about sending a message and setting a precedent.

BESHEAR: Absolutely. Again, this is a drug that, if used in the right way, can be a positive. But allowing this drug to be abused and abused in a way that is so similar, if not identical, to our pill-mill issue that we worked so hard to resolve - we worked so hard to shut them down - if we can't learn from our past and make sure we don't repeat those mistakes, then shame on us.

GREENE: Attorney General Beshear, thanks so much for taking the time. We really appreciate it.

BESHEAR: Thank you very much, David.

GREENE: That was the attorney general of Kentucky, Andy Beshear. Transcript provided by NPR, Copyright NPR.