Multiple factors have contributed to the failure to adequately address prescription drug abuse.

1. Pill mills.  Prescription drugs are prescribed in large quantities by corrupt doctors at "clinics" to "patients."  The pills can then be sold to others at significant profit.  

2. Inadequate and variable state laws allow pill mills to keep running.

3. When one state firms up its laws to shut down pill mills, corrupt owners move their operations to another state.

4. Communication between federal and state agencies is often sub-optimal.

5. Shame and denial prevent societal attention to the magnitude of the problem.

6. Universities have not made prescription drug abuse a priority, cooperate poorly with the DEA, and have been excessively concerned with protecting the university's image.

     Each of these problem areas will require substantially more work if we are to stop the upward spiral in deaths due to prescription substance abuse.  Much work has been done, but it has hardly stemmed the tide of this growing national problem.

     The next 5 pages (Drug Distribution, State Laws, Communication, Shame, and Colleges and Universities) will review specific aspects of the problem of prescription drug abuse.