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Drug audit part of probe at Indian clinics

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GREAT FALLS, Mont. (AP) - Federal drug agents are counting pain pills and reviewing medical records in an audit of clinics on Montana's Indian reservations, an audit launched in response to tribal concerns about abuse of prescription drugs.

''What we're hearing is that reservations have a horrendous drug problem and we want to know where it's coming from, where the source is,'' said Jim Tilley, the resident agent in charge of the federal Drug Enforcement Agency's Billings office.

The probe began earlier this year and the agency has completed audits on the Blackfeet, Crow, Northern Cheyenne, Rocky Boy's and Fort Belknap reservations, DEA officials said.

The agency first visited each reservation and talked with tribal leaders and law enforcement officials about the problems their communities face with prescription drugs.

Prescription drug abuse ''has really suppressed our people,'' said Edwin Little Plume, the tribal health and social services chairman for the Blackfeet Tribal Business Council. He and others are concerned that painkillers are prescribed too freely at IHS clinics and are used to put off expensive surgeries.

The availability of prescription pain pills has fueled an illicit drug trade, they said.

''Our people who really do need the pain medication - they fear being bothered, being threatened for their meds,'' Little Plume said.

The audit's second phase, now under way, involves counting pills and reviewing medical records.

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''What we're looking for is to see if someone is writing an overabundance of prescriptions and if it's the norm of what should be prescribed,'' Tilley said. ''Does the reservation, compared to similar communities in size and population, distribute a normal amount of methadone compared to other cities and towns in the state?''

The agency plans to go after prescription drug dealers.

DEA officials met with IHS officials Sept. 12 in Billings to clarify the current investigation. If any problems are found, the DEA will give the IHS the opportunity to correct them, Tilley said.

Reports on the audit will be made on each reservation and a final report will be sent in December to the DEA's Office of Diversion Control.

Fort Peck Tribal Health Director James Melbourne called the DEA investigation an indictment of the IHS system of health care delivery.

Faced with funding shortages, the service has to ration health care.

The health service estimates its patients receive $2,158 per person a year in health services - barely more than a third of the average of $5,921 per person for the general population in the United States.

In Montana and Wyoming, approximately 5,170 IHS patients are on the waiting list for surgery or other specialized care.

''We have to take a look at the reason behind this investigation. If they [the service] had the proper funding, you're probably not going to have this problem,'' Melbourne said. ''This also sends a message to IHS to look at the issue of managing people's pain.''