The New York Times

Published: June 16, 2008

MIAMI - From "Scarface" to "Miami Vice," Florida's drug problem has been portrayed as the story of a single narcotic: cocaine. But for Floridians, prescription drugs are increasingly a far more lethal habit.

An analysis of autopsies in 2007 released last week by the Florida Medical Examiners Commission found the rate of deaths caused by prescription drugs was three times the rate of deaths caused by illicit ones.

Law enforcement officials said the shift toward prescription-drug abuse, which began here about eight years ago, showed no sign of letting up and that the state must do more to control it.

"You have health care providers involved, you have doctor shoppers, and then there are crimes like robbing drug shipments," said Jeff Beasley, a drug intelligence inspector for the Florida Department of Law Enforcement, which co-sponsored the study. "There is a multitude of ways to get these drugs, and that's what makes things complicated."

The report's findings track with studies by the federal Drug Enforcement Administration, which has found that roughly 7 million Americans are abusing prescription drugs. If accurate, that would be an increase of 80 percent in six years and more than the total abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants.

Alcohol Still A Prevalent Concern

The report analyzed 168,900 deaths statewide. Cocaine, heroin and methamphetamines caused 989 deaths, it found, while legal opioids - strong painkillers such as Vicodin and OxyContin - caused 2,328.

Drugs with benzodiazepine, mainly depressants like Valium and Xanax, led to 743 deaths. Alcohol was the most commonly occurring drug, appearing in the bodies of 4,179 of the dead and judged the cause of death of 466 - fewer than cocaine (843) but more than methamphetamine (25) and marijuana (0).

The study also found that although the number of people who died with heroin in their bodies increased 14 percent in 2007, to 110, deaths related to the opioid oxycodone increased 36 percent, to 1,253.

Florida scrutinizes drug-related deaths more closely than do other states, so there is little basis for comparison with them.

It has also witnessed several highly publicized cases in recent years that have highlighted the problem. Last year, an accidental prescription drug overdose killed Anna Nicole Smith in Broward County.

Enforcement Is Lagging

Still, the state has lagged in enforcement. Thirty-eight other states have approved prescription drug monitoring programs that track sales. Florida lawmakers have repeatedly considered similar legislation, but privacy concerns have kept it from passing.

As a result, federal, state and local law enforcement officials say, Florida has become a source of prescription drugs that are illegally sold across the country.

"The monitoring plan is our priority effort, but that is not enough," William H. Janes, the Florida director of drug control, said in a statement accompanying the study. He said Florida was also looking at ways to curb illegal Internet sales and to encourage doctors and pharmacists to identify potential abusers.

Some local police departments have taken a more novel approach.

In Broward County on May 31, deputies completed a "drug takeback" in which $5 Wal-Mart, CVS or Walgreens gift cards were distributed to 150 people who cleaned out their medicine cabinets and turned in unused drugs in an effort to keep them out of young people's hands.

"The abuse has reached epidemic proportions," said Lisa McElhaney, a sergeant in the pharmaceutical drug diversion unit of the Broward County Sheriff's Office. "It's just explosive."

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