"To say we are going to do away with the problem in five years, we cannot do that," said Roland Gray, medical director of the Tennessee Medical Foundation and a U.S. Food and Drug Administration adviser on addiction issues. "I think they are headed in the right direction."
The new approach will depend on education, stepped-up law enforcement, and pill-tracking databases.
There is a particular emphasis on Florida, where 85 percent of all oxycodone pills in the nation are prescribed. Many of those end up along the East Coast and in Appalachia, where people take buses to Florida just to get pills in a phenomenon dubbed the "OxyContin Express."
"The key is that everyone realizes there is no magic answer to this," said Gil Kerlikowske, the White House drug czar. "It's a really complex problem."
When used properly, oxycodone and similar medications help people deal with chronic pain by slowly releasing key ingredients over many hours. Abusers crush the pills and sniff or inject them, resulting in a euphoric heroinlike high.
Overdose deaths from painkillers rose from less than 4,000 in the year 2000 to more than 11,000 in 2007, according to the most recent statistics available. Cocaine deaths went from 3,000 in the year 2000 to more than 5,000 in 2007; for heroin, the numbers have remained steady at about 2,000 each year.
Renee Doyle, a Fort Lauderdale mother whose son Blayne was in an oxycodone haze when he was struck and killed by a car in 2009, said he was able to get 240 pills on each monthly visit to a local pain clinic by doing little more than asking for them.
"I think people were just not paying attention and then greed took over," she said. "They are legal drug dealers, and they should be outlawed."
There are plenty of legitimate pain clinics. Those that cross the line dispense hundreds of pills per patient based on questionable diagnoses - or none at all. They often accept only cash and direct people to get prescriptions filled at specific pharmacies sometimes owned by the same operators.
To attack the problem, Kerlikowske said, "a real collaboration" is needed. "It's not just a prosecutor and DEA. It isn't just the medical profession. It's everybody."
The strategy announced by Kerlikowske's office calls for additional training on responsible prescription practices for the more than one million doctors authorized to prescribe certain controlled substances. The change would require congressional approval.
Another element of the strategy is a national education campaign featuring ads like the famous frying-egg "this is your brain on drugs" ad used in past efforts.
The plan also calls for continued aggressive law enforcement and better training, as well as modest increases of $123 million for drug prevention and $99 million more for treatment programs.
