Prescription drug abuse has become one of the biggest — if not the biggest — substance abuse problems in our region.

Like illicit street drugs that dominated the drug scene a few years ago, these powerful pain pills have led to crippling addictions and a black market that fuels property crime, violence and neglect.

But there are some big differences in the drug abuse trends.

The supply of street drugs such as cocaine and heroin depends on the ups and downs of international smuggling operations, where sheer possession is illegal every step of the way.

With pain pills, the supply is vast and entirely legal.

So, much of the pain pill legislation and law enforcement efforts so far have focused on the point of sale at drug stores and clinics, trying to prevent doctor shopping or overprescribing. But what about the manufacturers and distributors of these pills? Do they not have a greater responsibility to track their sales and be on the lookout for high volumes that might be a sign of diversion to illegal uses?

The West Virginia Attorney General’s Office thinks so.

Recently, state Attorney General Darrell McGraw filed lawsuits against 14 pharmaceutical drug distributors, contending their practices have contributed to the pain-abuse epidemic. While we are in no position to judge the merits of the individual cases, it certainly seems this part of the supply chain needs more scrutiny.

Among other things, the complaints seek to require companies to halt shipments that are not for legitimate medical needs and to flag suspicious drug orders to the state Board of Pharmacy. That might seem like a “no brainer,” but you have to question how closely suppliers have been watching.

As investigations into some of the “pill mill” clinics have shown, these operations often prescribe massive amounts of drugs — far beyond what might be expected for their location. For example, the filing pointed out a pharmacy in Kermit, population 300, received 3.1 million dosage units of hydrocodone in 2006.

McGraw also seeks damages, arguing that prescription drug abuse costs West Virginia millions of dollars each year in medical, court and law enforcement expenses.

While the state may be hoping for a big settlement as it won with tobacco companies, the more important strategy needs to be making sure pharmaceutical manufacturers and distributors become more responsible about monitoring the sales and supply of these powerful pain pills.

— Distributed by The Associated Press