Hydromorphone: Law and order

Last modified: Sunday, 31. May 2009 - 4:24 pm

About 30 million prescriptions and orders are written each year for controlled substances. It is not precisely known how many of these prescriptions and orders are diverted illegally, but it is known that these controlled substances account for more than 30% of all deaths and injuries associated with drug abuse. Hydromorphone is in this group of controlled substances, a group that also includes codeine, methadone, hydrocodone, oxycodone, and amphetamine. The profitability of selling these prescription drugs is high. Even at market value, most of these drugs only cost pennies per unit to buy but are sold for several times that value on the street.
The DEA currently believes that physicians and pharmacists are the primary forces that allow this criminal behavior to occur. It is their easy access to these controlled substances that creates a pipeline of drug distribution to criminals who sell them on the street.
The DEA investigated a physician in Texas over a four-year-period to uncover the astonishing fact that this man had written 7% of all hydromorphone prescriptions in the state of Texas between 1988 and 1990. This doctor had written more than 500 prescriptions that totaled more than 54,000 dosage units of hydromorphone during this two-year period. The man sold the prescriptions for $500 each, and had his receptionist create fictitious patient records to help disguise the criminal activity. The man received 33 months in prison for drug trafficking and was ordered to pay $80,000 restitution to the Texas Medicaid program.
The success of legal prohibition of opiates and related compounds can be considered mixed at best. Most economists and legal scholars believe the prohibition of drug trade and use increases the price of the drugs on the black market. Strong penalties for using drugs, such as illicit opiates, discourages addicts from receiving treatment, and leads many to commit crimes to pay for the high price of drugs. Economists point to the relatively inexpensive price of legal but prescribed narcotics compared to the price on the streets, where both legally and illegally produced narcotics are sold at exorbitant prices. Still, evidence gathered from countries where narcotic use is decriminalized or has less serious penalties suggests addiction rates are as high or higher, and crime rates are still relatively high.

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