LEXINGTON, Ky. (AP) - Dr. Karen Shay recognized the changes in her teenage daughter Sarah - the withdrawal from long-time friends, weight loss and a defiant attitude toward family - all hallmarks of a prescription drug addiction. Sarah got clean after two years, but died in 2006 at age 19 after taking methadone and Xanax at a party with friends, passing out and suffocating.
"All I remember is screaming and getting violently ill," said Shay, a dentist in Morehead in northeast Kentucky. "It devastated us."
It's a death Shay believes could have been avoided if Kentucky and other states had tighter control over pain pill prescriptions and more closely cooperated to close off the "pill pipeline" that runs from states such as Florida, Tennessee and Georgia to Kentucky.
Some states, such as Florida, have already begun a crackdown, tightening the requirements for prescribing painkillers.
Kentucky Attorney General Jack Conway said on Thursday legislation will be proposed in the coming weeks aimed at imposing similar regulations, as well as create a more stringent tracking program for law enforcement and regulators to keep tabs on who is prescribing painkillers and in what volume.
Conway, who spoke along with Florida Attorney General Pam Bondi at the Different Faces of Substance Abuse conference in Lexington, said last year, an estimated 60 percent of pain pills being sold illegally in Kentucky came from Florida. That supply is now closing because of the steps taking in the Sunshine State. But suppliers are now moving to other nearby states because of a lack of coordination between law enforcement agencies and, in some cases, weaker laws, Conway said.
"People in this state, obviously, can drive to another state," Shay said. "It's a national problem."
The lack of legislation aimed at prescription pill abuse in neighboring Missouri gives Kentuckians a nearby outlet to get the drugs, making it harder to keep the pills out of Kentucky, which has the third-highest use of prescription medications in the nation, Conway said.
"Missouri is a concern to me," Conway said.
A message left for the Missouri Attorney General's Office was not immediately returned Thursday.
Hydrocodone is the most prescribed painkiller in Kentucky, accounting for 42.8 percent of all painkillers prescribed in the state. Oxycodone is second, prescribed 15.5 percent of the time, said Dave Hopkins, who oversees the Kentucky All Schedule Prescription Electronic Reporting System (KASPER), which tracks controlled substance prescriptions dispensed within the state. The average age of a first-time prescription drug abuser in Kentucky is 11-years-old, Hopkins said.
"That's just staggering to me," he said.
Carlos Cameron with Operation UNITE, an anti-drug task force operating in 29 eastern Kentucky counties, said the rampant pill problem there is fueled in part by people trekking to larger, urban areas in northern Kentucky, Lexington and Louisville, then returning to the Appalachians. The drug abuse is driven by poverty, hopelessness and addictions stemming from injuries sustained in the coal industry, Cameron said.
"It's an epidemic," Cameron said.
Along with urban areas, many of those painkillers also came from Florida, where clinics catered to people from Ohio and Kentucky willing to drive south to buy as many as 300 pills in a single prescription, Bondi said. In one case, a clinic had 1,700 total patients, including 1,100 from Kentucky, Bondi said.
"In Florida, we had more pain clinics than McDonald's," Bondi said.
Conway is hoping tighter regulations will allow Kentucky to replicate some of the success Bondi has experienced in Florida, where the number of pain clinics in has fallen from 943 before the legislation passed last year to 518 today.
Bondi said the stricter monitoring program is responsible for that drop, as well as Florida now having only 11 of the Drug Enforcement Administration's top 100 doctors dispensing oxycodone. In 2010, before the law went into effect, 98 of the top 100 were from Florida.
"It's up, it's running, it's been incredibly successful," Bondi told The Associated Press in an interview.
Shay, who described herself as looking for "a new normal" six years after her daughter died, hopes Kentucky can follow Florida's lead and close down the pill pipelines.
"Why don't we have something that specifically addresses the prescription pill abuse?" Shay asked. "I'm hoping that's kind of where we're heading."
Online: Florida Attorney General Pam Bondi: http://www.myfloridalegal.com
Kentucky Attorney General Jack Conway: http://ag.ky.gov
Different Faces of Drug Abuse: http://www.facesofdrugabuse.org