Drug laws encompass many illicit activities: possession, manufacture, sale, trafficking, distribution, and transportation and are based on the type and quantity of drug. Despite prescription drugs being generally legal, there is a fine line as to when these drugs are handled illicitly.
According to the National Institute on Drug Abuse (NIDA), misuse of prescription drugs involves taking dosages in a manner other than prescribed, using another person’s prescription, or taking a prescription medication in order to reach a “high.” With a steady increase in drug prescriptions—especially for opioids—the potential for misuse and abuse is even greater.
There are three classes of prescription medications that are most commonly misused: opioids, depressants, and stimulants. Opioids include pain relievers such as oxycodone and hydrocodone. Depressants include such drugs as tranquilizers, hypnotics, and sedatives. Stimulants include ADD/ADHD treatments and prescription diet pills.
Statistics
Over the past 15 years, prescription drug misuse and abuse have increased as evidenced by more emergency room visits, treatment admissions for addiction, and overdose deaths, the latter of which have increased nationwide five-fold since 1999. Further, prescription opioid abuse alone carries with it a high price tag—more than $78 billion in lost work, healthcare, crime, and productivity.
In Minnesota alone, opioids are a serious problem, thus resulting in more than 400 opioid-related deaths in 2018 alone.
Nationwide, in 2016, opioids were responsible for two thirds of the nearly 64,000 overdose deaths and opioid abuse has been blamed as the primary responsibility for lowering life expectancy in the US over the past few years.
Many experts assert the opioid crisis isn’t just opioids. Both illicit and legal prescription drugs have contributed to the problem; however, prescription opioid use has increased exponentially over the past few years and has received the lion’s share of attention in legislative and medical efforts to combat the problem.
Minnesota prescription drug crimes and penalties
Pursuant to Minnesota law, penalties are harsh for drug offenses including prescription drugs. Among these—specifically Schedule II controlled substances which include prescription medications that carry a high potential for abuse—criminal sanctions can include excessively long prison sentences and high fines.
Possession for personal use is a fifth-degree felony that is punishable by up to five years in prison and up to $10,000 in fines. Possession with the intent to sell is a fourth-degree felony punishable by up to 15 years in prison and up to $100,000 in fines.
Sanctions increase for prescription drug offenses committed in drug-free zones such as schools, churches, treatment facilities, public housing, or parks. Sentence enhancements include up to 20 years in prison and up to $250,000 in fines for possession and up to 25 years in prison and as much as $500,000 in fines for sale and/or trafficking in a drug-free zone.
Minnesota efforts
In Minnesota, prescription drug abuse and the high consumer cost for such drugs, thus resulting in a robust black market, is such a problem that back in May, the 2019 state legislature passed a bill—the Pharmacy Benefit Managers bill (Senate File 278)—to address the issue. The bill overwhelmingly passed the Senate 67-0 and the House 130-2 and is currently waiting for Governor Tim Walz’s signature.
Pharmacy Benefit Managers (PBMs) are private companies originally created to assist insurance companies with the complexities of prescription drug coverage. The rapidly increasing cost of prescription medications and resulting monopoly and influence that require drug manufacturers to pay rebates to get onto formularies without any real oversight or transparency have served to exacerbate the problem.
The bill would require Minnesota-based PBMs to be licensed and pay an $8,500 annual fee to cover state regulation costs. It also permits pharmacies to dispense equivalent medications that may not be on a specific insurance policy’s formulary and prohibits pharmacists from urging patients to pay cash for the drugs.