commander, warren county, ohio, drug task force coordinator- southwestern ohio hidta major case...
TRANSCRIPT
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Commander, Warren County, Ohio, Drug Task Force
Coordinator- Southwestern Ohio HIDTA Major Case Initiative
President-National Association of Drug Diversion Investigators (NADDI)
32 years Cincinnati Police Division
Commander Pharmaceutical Diversion Squad
Six investigators, one secretary
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DEFINITION?
Criminal deviation or counterfeiting of a prescription drug.
Illegal removal of a prescription drug at any point in its path from manufacturer to patient
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Most likely drug to be abused in the workplace
Obtain through insurance
“Only prescription drugs”
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SAMHSA SURVEY 2003:
6.2 million people abused Rx drugs
Significant increase in 12-17 YOA in abuse of Rx drugs
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0
2
4
6
8
10
12
14
16
1
Marijuana
Prescription Drugs
Cocaine or Crack
Ecstasy
Methamphetamine
Inhalants
Heroin
LSD
millions
Source: U.S. Substance Abuse and Mental Health Services
Most Abused Drugs
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According to ONDCP- Identified 34 rogue Internet pharmacies in 2006
Dispensed over 98 million dosages of hydrocodone
Would take 1,118 average pharmacies to equal amount dispensed by the 34 illegal Internet apothecaries
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Often high-price medications Produced “legally” in India Packaging often made in China Unknown components in drug Often made in unsanitary conditions
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Usually addicted individual involved CII’s often the target Weapon or threat of weapon involved Potentially very dangerous situation Cooperate with the offender Remind police to check ER runs Rx Patrol should be utilized
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Involve the after-hours entry of a pharmacy Smash and grab likely addicted perpetrator Usually planned criminal enterprises Entry through the roof-adjoining business Alarm disabled Possible entry into safe Hundreds of thousands of dollars street value Rx drugs often removed Rx Patrol should be utilized
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Funded by Purdue Pharma Reports of pharmacy robbery Reports of pharmacy burglary Reports of major pharmacy crime Database for law enforcement Only as good as the information provided
by LE and pharmacy personnel Reporting can be done online
www.rxpatrol.org
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Alprazolam with roots in Mexico Not dispensed in the United States Delivered to Southwest Ohio 200,000
dosage units a month for 3.5 years 100% profit made on each load Arrests made and over 100,000 dosage
units confiscated Activity continues
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Elvis Presley - pain/sleeping medication
Sonny Bono - pain medication
Bret Favre - pain medication
Matthew Perry- pain medication
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ONDCP indicates over 2 million teens abused Rx drugs (2007)
Estimates that 2,500 teens per day initiate Rx abuse and now top source of abuse for those 12 & 13 YOA (ONDCP 2007)
Associated Press December 2005- 9.5% of HS Seniors abused hydrocodone
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Parents medicine cabinet
Chronic pain patients
Garbage (fentanyl patches)
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Product still popular with juveniles 1 in 10 teens have abused (2 million) Large doses consumed at one time Often ends in
vomiting/dizziness/confusion Overdoses Much of it stolen if not behind the
counter “Triple C” currently most popular
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HYDROCODONE (Vicodin, Lortab, Lorcet) $6- $8
OXYCODONE (Percocet, Percodan, Tylox) $6 - $8
(OxyContin- $.50-1.00 mg.)
ACETAMINOPHEN WITH CODEINE (Tylenol #3, Tylenol #4) $3 - $5
DIAZEPAM (Valium) $1 - $2
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CARISOPRODOL (Soma) $3 - $4
ALPRAZOLAM (Xanax) $3 - $4
MEPERIDINE (Demerol) N/A (H/P Usage)
METHYLPHENIDATE (Ritalin) $10 - $12
HYDROMORPHONE (Dilaudid) 4mg - $60
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Stadol Nasal Spray
Methadone
Tramadol (Ultram)
Phentermine (Adipex)
Fentanyl patches (Duragesic/Actiq)
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Less risk of overdose
Easier to obtain through “legal” script
Cheaper than cocaine and heroin
Less risk of detection - lack of enforcement
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Alteration of script is a felony in Ohio
Changing doses, refills or strength
White out
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Nail polish remover
Photocopying
Computer generated prescriptions
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Employee of Health Professionals
Phony call-ins
After hours “patient” scam
Doctor Shopping
Pill Brokers
ER Shopping
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• Slam car doors and trunks on hands • Slam windows on hands & fingers• Carry syringes with blood to squirt in
their mouth to demonstrate bleeding• Carry kidney stones in a jar to ER• Insert objects into open wounds• Deliberately irritate root canal work• Beat on foot with 4.5 LB hammer
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• Every bit as addicted as the heroin and cocaine addict
• Spends most of their waking hours planning on how to get their drugs
• Consumes much of their time deciding how to scam YOU!
• Not illegal to be scammed!
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• Compliments physician• Deliberately mispronounces drug name• Agitated when cut off drugs of choice• Threatens lawsuit• Leaves abruptly when scam does not
work
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PERIODIC URINE SCREENS (Include hydrocodone/oxycodone)
PILL COUNTS
CS RX INDICATES OTHER SCRIPTS WRITTEN
CHECK WITH RPH ON FILLING OF NON-CS SCRIPTS
MEDICATION AGREEMENT AND VIOLATIONS
DOCUMENT! DOCUMENT! DOCUMENT!
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FAMILY MEMBER/CARE GIVER DIVERSION
LIMIT CS IN HOUSEHOLD
DO NOT POST DATE SCRIPTS
“DO NOT FILL UNTIL” ISSUE (CII)
REMEMBER “3 DAY RULE” FOR ADDICTS
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• Drug seekers keep you from legitimate patients
• Lack of addressing the issue will increase the problem
• Perpetuates patient’s addiction or trafficking by ignoring the problem
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Diversion negatively impacts legitimate patients
Requires joint effort and balance between HP and LE
Vast majority of patients are legitimate Vast majority of HP’s are legitimate
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