Operations Division Office of Diversion Control Denise Curry, J.D. Deputy Director Drug Enforcement...

Operations Division Operations Division Office of Diversion ControlOffice of Diversion Control

Denise Curry, J.D.Denise Curry, J.D.Deputy DirectorDeputy Director

Drug Enforcement Administration

Drug Addiction Treatment Act Drug Addiction Treatment Act (DATA)(DATA) of 2000 of 2000

DEA started scheduled regulatory DEA started scheduled regulatory investigations October 1, 2003investigations October 1, 2003

Investigations usually last one to Investigations usually last one to two hourstwo hours

Regulatory investigations are one Regulatory investigations are one doctor per diversion group once doctor per diversion group once every fiscal yearevery fiscal year

3.2%

96.8%

DATA DATA Waived Practitioners* Waived Practitioners*

Registered as DATA Waived*12,826 Practitioners

* as of 01/17/2008 per DEA Oracle Database

DATA Waived Regulatory Investigations

425 Practitioners as of 12/31/2007

Drug Enforcement Administration, Operations Division, Office of Diversion Control

Surrendered Unique IdentifierSurrendered Unique Identifier

Practitioner diedPractitioner died Facility where practitioner worked Facility where practitioner worked

decided too costly to initiate decided too costly to initiate treatment programtreatment program

Practitioner working for NTP Practitioner working for NTP instead of sole practitionerinstead of sole practitioner

Practitioner changed his mindPractitioner changed his mind No clients for this serviceNo clients for this service Psychiatric facility does not allow Psychiatric facility does not allow

administering or prescribing office administering or prescribing office based opiate treatmentbased opiate treatment

DATA Waived Regulatory DATA Waived Regulatory InvestigationsInvestigations

DATA Waived Regulatory DATA Waived Regulatory Investigations Investigations

2007

51.7%

10.5%4.2%

33.6%

No Problems Cited253 Practitioners

Problems Cited74 Practitioners

Yet to Establish DATA Waived Practice57 Practitioners

Surrendered Unique Identifier26 Practitioners

35Verbal Warnings35Verbal Warnings record keeping and dispensing record keeping and dispensing

violationsviolations

23 Letters of Admonition23 Letters of Admonition record keeping and dispensing record keeping and dispensing

violations and security violationsviolations and security violations 8 Surrendered Registrations for 8 Surrendered Registrations for

Cause2 Show Cause ProceedingCause2 Show Cause Proceeding 1 Civil Action1 Civil Action

5 Undergoing Active Investigations5 Undergoing Active Investigations

DATA Waived Regulatory DATA Waived Regulatory InvestigationsInvestigations

Problems Cited/Action TakenProblems Cited/Action Taken

Bubrenorphine RxBubrenorphine Rx

0

500

1000

1500

2000

2500

2002 2003 2004 2005 2006 2007

BuprenexSubutexSuboxoneTotal

ThousandsSource: IMS National Prescription Audit retrieved 02/12/08

From 2004 thru 2007 there was a 500% increase in buprenorphine prescriptions

Source: IMS National Prescription Audit retrieved 02/12/08

Subutex and Suboxone 8mg Tablets60,436,167 dosage units

71.6%

Buprenorphine Distribution Buprenorphine Distribution to Retail Registrantsto Retail Registrants

January 1, 2007 – December 31, 2007January 1, 2007 – December 31, 2007

Source: ARCOS Date Prepared: 2/20/2008Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis Unit

Subutex and Suboxone 2mg Tablets18,171,516 dosage units

21.5%

Buprenex and BuprenorphineInjectables

5,816,281 dosage units6.9%

Hospitals2,120,550 dosage units

3.5%

NTP’s441,930 dosage units

0.7%

Practitioners1,068,371 dosage units

1.8%

Mid-Level Practitioners120 dosage units

<0.1%

Pharmacies56,805,196 dosage units

94.0%

Distribution ofDistribution of Subutex and Suboxone (8mg Subutex and Suboxone (8mg Tablets) Tablets)

to Retail Registrantsto Retail RegistrantsJanuary 1, 2007 – December 31, 2007January 1, 2007 – December 31, 2007


Teaching Institutions0 dosage units

0.0%

Hospitals1,354,488 dosage units

7.5%

NTP’s197,760 dosage units

1.1%

Practitioners298,560 dosage units

1.6%

Mid-Level Practitioners0 dosage units

0.0%

Pharmacies16,320,618 dosage units

89.8%

Distribution ofDistribution of Subutex and Suboxone (2mg Subutex and Suboxone (2mg Tablets) Tablets)

to Retail Registrantsto Retail RegistrantsJanuary 1, 2007 – December 31, 2007January 1, 2007 – December 31, 2007


Teaching Institutions90 dosage units

<0.0%

1,089

880

576

472

372356

318291 280 277

169

0

200

400

600

800

1,000

1,200

GR

AM

S P

ER

100

K P

OP

UL

AT

ION

GR

AM

S P

ER

100

K P

OP

UL

AT

ION

BuprenorphineBuprenorphineTop 10 StatesTop 10 States

2007 ARCOS Distribution DATA2007 ARCOS Distribution DATA

VT ME MA RI CT UT MD PA WV NJ U.S.

Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis Unit

Source: ARCOS Date Prepared:

01/25/2008

Average

Subutex and Suboxone 8mg TabletsSubutex and Suboxone 8mg Tablets Distribution Per 100,000 Population (Pharmacies Only) Distribution Per 100,000 Population (Pharmacies Only)

January - December, 2007January - December, 2007WA

ORMT

IDWY

ND

SDMN

IANE

WIMI

CO KS MOIL IN

UTNV

CA

AZ NMOK

TXAK

AR

LA

TNKY

MS AL GASC

NC

OH

VA

PA

NY

MEVT

CT

NJ

MD

RI

DC

DE

HI

VW

FL

MAHN

PR

U.S. Average: 20,451 Dosage Units

Above Average = 25,565 Dosage Units or more

Average = 15,338 – 25,564 Dosage Units

Below Average = 15,337 Dosage Units or less


(146)

(17)

(46)

(262) (27)

(1,440)

(135)

(CT-262)

(37)

(70)

(780)

(310)

(54)

(24)

(325)(168)

(26)

(48) (129)

(189)

(206)

(524)

(MA-651)

(555)(118)

(98)

(119)

(24)

(35)

(93)

(NH-46)

(NJ-573)

(139)

(1,572)

(203)

(12)

(357)

(72)

(151)(796)

(139)

(85)

(114)

(8)

(201)

(611)

(164)

(VT-148)

(200)

(258)

(WV-76)

(175)

Numbers in parenthesis represent number of Data Waived Doctors

U.S. Average = 1,708 dosage units

MA Average = 4,917 dosage units

Above = 6,148 dosage units or more

Average = 3,688 – 6,147 dosage units or more

Below = 3,687 dosage units or less

012(14)

013(4)

010(22)

015(21)

014(8)

017(30)

018(33)

019(33)

027(53)

020(28)

026 (16)

020(28)

022(8)

016(31)

011

025

(12)

023(23)

021(209)

024

(83)

State of Massachusetts by Zip Code State of Massachusetts by Zip Code 2007 Pharmacy Purchases of2007 Pharmacy Purchases ofSubutex and Suboxone 8mgSubutex and Suboxone 8mg


(22)

Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis UnitSource: ARCOS Date Prepared: 02/20/2008

164(6)

163(4)

181(14)

165(11)

161(6)

167(0)

162(2)

160(6)

157(7)

158 (5)

169(1)

159(16)

156(15)

177(5)

154 (7)

153 (8)

168(15)

175(10)

170(32)

173(8)

172 (6)

166(21)

155 (4)

176(21)

195(10)

174

918)

196(11)

183(4)

184(7)186

(4)

188(0)

187

(15)

178

(11)

190

(120

)

185(11)

194(29)

189(18)

180(9)

193(32)

179(1)

182(4)

191(118)

151(17)

152

(96)

150(17_

171

(14)

State of Pennsylvania by Zip Code State of Pennsylvania by Zip Code 2007 Pharmacy Purchases of2007 Pharmacy Purchases ofSubutex and Suboxone 8mgSubutex and Suboxone 8mg

U.S. Average: 1,708 dosage units



PA Average = 2,240 dosage units Above = 2,801 dosage units or more Average = 1,680-2,800 dosage units


U.S. Average = 1,708 dosage units

FL Average = 1,593 dosage units

Above = 1,992 dosage units or more Average = 1,195-1991 dosage units


320 (28)

322(54)

323 (6)

324(4)

325(22)

326(22)

327(27)(27)

328

335

(10)

336(50)

337(33)

338(15)

339(27)

341(17)

342(27)

344(16)

346

(22)

347(14)

349(25)

321(16)

330(49)

329

(18)

334(112)

333(52)

331(85)

State of FloridaState of Florida

2007 Pharmacy 2007 Pharmacy Purchases ofPurchases of

Subutex and Suboxone 8mgSubutex and Suboxone 8mgby Zip Codeby Zip Code

Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis UnitSource: ARCOS Date Prepared: 02/20/2008


20032003 20042004 20052005 20062006 20072007 TotaTotall

MAMA 44 125125 291291 501501 598598 15191519

PAPA 00 1818 3939 184184 241241 482482

MDMD 00 66 2020 108108 236236 370370

NJNJ 44 99 3737 7272 137137 258258

VAVA 00 1111 2121 4545 9696 173173

States With the Highest Number of Laboratory Exhibits

(Source: NFLIS - State and Local Forensic Laboratories)

Buprenorphine Buprenorphine Federal, State and Local Federal, State and Local

Laboratory ExhibitsLaboratory Exhibits(Source: NFLIS and STRIDE)(Source: NFLIS and STRIDE)

0

200

400

600

800

1000

1200

1400

1600

1800

2000

2003 2004 2005 2006 2007

(628% ↑)

(137% ↑ )

(123% ↑)

(54% ↑)

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Operations Division Office of Diversion Control Denise Curry, J.D. Deputy Director Drug Enforcement...

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