Drug war’s focus turns to pharmaceuticals [Star-News, Wilmington, N.C.]
By Brian Freskos, Star-News, Wilmington, N.C. | |
McClatchy-Tribune Information Services |
She asked the doctor,
Not long after the agent's exchange with Dyer, detectives leveled drug trafficking charges against the doctor for running what is alleged to have been a "pill mill," an easy source of prescriptions for narco-grade drugs while masquerading as a legitimate pain clinic.
The case, details of which were gleaned off investigators' sworn affidavits, offers an example of the shifting focus in anti-drug efforts: Authorities are concentrating less on what is trafficked by cartels and more on what is coming out of doctor's offices and pharmacies, according to dozens of interviews with law enforcement officials from
Pill seizures in many local jurisdictions have hit record levels in recent years.
Between January and October, for example, the
But the altered landscape of the illegal drug trade has given rise to new challenges.
Catching up
Critics say many areas are behind the curve, with officers who are undertrained and ill-equipped to handle the unmatched complexities of prescription drug cases.
That leaves agencies struggling to get a stranglehold on what the Obama administration has proclaimed as the nation's fastest-growing drug problem.
Most agencies have assigned few, if any, officers to exclusively handle prescriptions, which, according to the
"I think you need a specialized person, a specialized unit, to handle these cases," said
Prescriptions vary from other drugs in significant respects.
For one, they are legal but tightly regulated.
Detectives must often navigate a labyrinth of paperwork and comprehend complex medical jargon to develop enough evidence to bring criminal charges against rogue doctors and pharmacists and traffickers.
They need a basic understanding of medical law, how health insurance and
That does not mean authorities have sat idle watching abuse skyrocket. On the contrary, federal, state and local governments have made unified attempts to address the issue on several fronts, but some contend that much more needs to be done.
On Tuesday, the
Prescription abuse is driving much more than just a rise in overdose deaths. It is ratcheting up a number of crimes such as robbery and burglary as well.
As of
Some residential break-ins have been reported in which the burglar passed over the big-screen TV and stole nothing but the contents of the medicine cabinet.
The home, experts say, also is a place where curious teenagers can find medications, stealing, for instance, their parents' pill bottles to get high.
The trend prompted the
At the same time, the
The amount of drugs surrendered at these disposal sites has led some officials to call for the creation of a system where people can throw away pills year-round.
The state attorney general's office rolled out pilot programs in about a half-dozen counties that now have permanent drop boxes. A spokeswoman said the SBI is looking for grant money so all 100 counties can enjoy such a site.
State Attorney General
"In fact," Cooper said, "drug overdose from prescription drugs is second only to car accidents causing the death of young people in
Investigating Rx abuse
For all its differences, there are some elements of prescription abuse similar to that of other drugs.
Detectives, for example, build networks of informants by making low-level arrests and rolling them up to help bring down dealers supplying large quantities of illegal pills.
It works the other way, too.
Detective
Other methods include people passing fake prescription slips or phoning a pharmacy pretending to be a doctor calling in a prescription.
Hamilton said that besides Dyer, not many local health care practitioners have come onto his radar, though he acknowledged that a few are under investigation. Mostly, though, he said his time is eaten up by prescription fraud and doctor shopping.
"I have 23 voicemails on my phone right now, and I can almost guarantee you they're all from pharmacies," he said one recent afternoon in his office, explaining that he has made a point to visit
Because of patient privacy laws, Hamilton does not enjoy unfettered access to the state's prescription monitoring system, a program that lets doctors see if a patient has received medications from other health care practitioners.
Hamilton has to show enough probable cause to draw a warrant to obtain a patient profile from the monitoring system.
Doctors, however, can check the record, and they often tip off Hamilton when something seems amiss. The doctor can tell Hamilton who the patient has visited. Hamilton interviews those other doctors, building enough evidence to obtain a court order for the profile.
"You get away with it until the pharmacist picks up on it, until the doctor picks up on it," he said. "Once you start doing this, you leave a paper trail."
"This case here started in May of this year, and I'm still not done," Hamilton said, dropping a manila folder stuffed with sheets of paper on a table.
Shifting manpower
It is rare for a city the size of
The SBI has 10 agents dedicated to pharmaceuticals statewide. Cooper said he wants to add more, but recent budget contractions eliminated 42 agent positions, and the budget outlook is murky.
On the federal level, the
The DEA currently run 37 such squads of varying size around the country, including one in
Primarily, law enforcement officials say, they see addicts seeking painkillers like hydrocodone and oxycodone, which are available under the brand names Percocet, Vicodin and Oxycontin. Addicts also seek anti-anxiety medications like Xanax. Among college students and other young people, police say stimulants like Ritalin and Adderall are particularly popular.
Interstate trafficking
When addicts run into obstacles obtaining prescriptions in
Police say carloads of addicts and drug dealers from Northern and Mid-Atlantic states have frequently driven south to visit pill mills, especially in the
Experts describe pill mills as storefront operations that are walk-in only, accept nothing but cash, often have armed guards and provide only a cursory medical exam -- if one at all -- before dispensing fistfuls of potent medications. They are commonly located in strip malls, and easy to spot because a line usually snakes out the front door, with people waiting outside before the office even opens in the morning.
In the first six months of 2010,
In one high-profile investigation, dubbed Operation Snake Oil, prosecutors indicted six
The government seized
For the community, the case exemplified the scale of the problem there.
In the past year and half though, the spotlight has swung farther north. Crackdowns in
Over time, law enforcement has watched the
"It's a new world," as one
The exodus from the Sunshine State has sent pill mills into
But he said there might exist many more, adding, "We really lost count."
"Usually, we're pretty proactive on this," he said. "But we just dropped the ball."
The explosion has prompted addicts and traffickers to converge on
A robust monitoring program in
Pharmacists in
"We have people riding to
While police try to make gains in their battle against drug abuse, shrinking the availability of prescriptions might give rise to another problem: Addicts dependent on opium-derivatives like oxycodone face withdrawal symptoms unless they find something to satisfy their cravings. And that something is likely to be heroin.
"It's a pretty ugly transition," Horn said, "and I think the effects of it are going to be devastating."
On Twitter: @BrianFreskos
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