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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
Source: ARCOS Date Prepared: 2/20/2008Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis Unit
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
Source: ARCOS Date Prepared: 2/20/2008Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis Unit
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
Source: ARCOS Date Prepared: 2/20/2008Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis Unit
(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
Numbers in parenthesis represent number of Data Waived Doctors
(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
Source: ARCOS Date Prepared: 02/20/2008Drug Enforcement Administration, Office of Enforcement Operations, Pharmaceutical Investigations Section, Targeting and Analysis Unit
Numbers in parenthesis represent number of Data Waived Doctors
PA Average = 2,240 dosage units Above = 2,801 dosage units or more Average = 1,680-2,800 dosage units
Below = 1,679 dosage units or less
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
Below = 1,194 dosage units or less
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
Numbers in parenthesis represent number of Data Waived Doctors
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% ↑)