The tragedy and pervasiveness of prescription drug abuse is well-documented.  According to the latest National Survey on Drug Use and Health  released last week, 1.9 million Americans used prescription painkillers for a nonmedical purpose for the first time in 2012.  The tireless efforts of DEA and other law enforcement agencies to address this issue are being supplemented by the likes of The Clinton Foundation.  For public and private sector efforts to be effective in addressing prescription drug abuse they must understand and address, among other issues, the source of supply of prescription drugs. The National Survey reveals that 69% of individuals misusing prescription drugs obtain the drugs from a family member or a friend while only 6.3% obtain their prescription drugs from drug dealers, rogue internet sites and through “doctor-shopping” (obtaining the same prescription drug from more than one doctor). The drugs from relatives and friends are free the vast majority of the time, although thefts from and sales by relative and friends are the source of supply for nearly 15% of those misusing prescription drugs.  Drug take-back days are a great way to reduce the supply in the medicine cabinet, but with only two take-back days per year other steps must be taken to reduce easy access to prescription medications for those who misuse these drugs.  We often discuss enforcement and compliance issues here at the DEA Chronicles.   But tough enforcement and strict compliance will not solve this problem when family members and friends are the suppliers of the prescription drugs that are misused.  And no single strategy will solve the problem of prescription drug abuse.  But here are two ideas that can minimize the supply of drugs in medicine cabinets.  1)  Incentivize prescribers to prescribe modest amounts of prescription controlled substances to treat acute pain.  This will require health insurers, medical boards, and patient advocacy groups to have meaningful discussions about the pros and cons of limiting the number of dosage units prescribed to treat acute pain without degrading patient care.  2) Authorize pharmacies to accept returns of unneeded prescription controlled substances (we have previously written about DEA’s divided mind on drug returns).  Surely if we can trust pharmacies registered with the DEA to dispense controlled substances, we can trust them to accept returns of those same controlled substances from patients who don’t need them.  What is your idea for reducing the supply of unneeded controlled medications that fill the nation’s medicine cabinets?