Transcript H/R Presentation for Non-H/P




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

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

Most likely drug to
be abused in the
workplace

Obtain through
insurance

“Only prescription
drugs”
SAMHSA SURVEY 2003:
6.2 million people
abused Rx drugs
 Significant increase
in 12-17 YOA in
abuse of Rx drugs

16
14
Marijuana
Most Abused Drugs
12
Cocaine or Crack
10
millions
Prescription Drugs
8
6
Ecstasy
4
Inhalants
2
Heroin
0
LSD
Methamphetamine
1
Source: U.S. Substance Abuse and Mental Health Services

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





Often high-price medications
Produced “legally” in India
Packaging often made in China
Unknown components in drug
Often made in unsanitary conditions







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








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







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
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


Elvis Presley - pain/sleeping medication

Sonny Bono - pain medication

Bret Favre - pain medication

Matthew Perry- pain medication

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

Parents medicine cabinet

Chronic pain patients

Garbage (fentanyl patches)
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


HYDROCODONE (Vicodin, Lortab, Lorcet)

OXYCODONE (Percocet, Percodan, Tylox)
$6- $8
$6 - $8
(OxyContin- $.50-1.00 mg.)

ACETAMINOPHEN WITH CODEINE

DIAZEPAM (Valium) $1 - $2
(Tylenol #3, Tylenol #4) $3 - $5

CARISOPRODOL (Soma) $3 - $4

ALPRAZOLAM (Xanax) $3 - $4

MEPERIDINE (Demerol) N/A (H/P Usage)

METHYLPHENIDATE (Ritalin) $10 - $12

HYDROMORPHONE (Dilaudid) 4mg - $60

Stadol Nasal Spray

Methadone

Tramadol (Ultram)
n
Phentermine (Adipex)
n
Fentanyl patches (Duragesic/Actiq)

Less risk of overdose

Easier to obtain through “legal”
script

Cheaper than cocaine and heroin

Less risk of detection - lack of
enforcement

Alteration of script is a felony in Ohio

Changing doses, refills or strength

White out

Nail polish remover

Photocopying

Computer generated prescriptions

Employee of Health Professionals

Phony call-ins

After hours “patient” scam

Doctor Shopping

Pill Brokers

ER Shopping
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
•
•
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!
•
•
•
•
•
•
Compliments physician
Deliberately mispronounces drug name
Agitated when cut off drugs of choice
Threatens lawsuit
Leaves abruptly when scam does not
work

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!

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
•
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
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
