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WARREN COUNTY DRUG TASK FORCE

WARREN COUNTY DRUG TASK FORCE. JOHN BURKE, COMMANDER P.O. BOX 898 LEBANON, OHIO 45036 PHONE: (513) 336-0070 CELL: (513)-623-3278 FAX: (513) 336-9097 E MAIL: Burke@wcdtf.org. PHARMACEUTICAL DIVERSION. Commander, Warren County, Ohio, Drug Task Force

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WARREN COUNTY DRUG TASK FORCE

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  1. WARREN COUNTY DRUG TASK FORCE JOHN BURKE, COMMANDER P.O. BOX 898LEBANON, OHIO 45036 PHONE: (513) 336-0070CELL: (513)-623-3278 FAX: (513) 336-9097 E MAIL: Burke@wcdtf.org

  2. PHARMACEUTICAL DIVERSION • 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

  3. PHARMACEUTICAL DIVERSION • 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

  4. SCOPE OF THE PROBLEM • Most likely drug to be abused in the workplace • Obtain through insurance • “Only prescription drugs”

  5. SCOPE OF THE PROBLEM SAMHSA SURVEY 2003: • 6.2 million people abused Rx drugs • Significant increase in 12-17 YOA in abuse of Rx drugs

  6. MOST ABUSED DRUGS

  7. INTERNET DIVERSION • 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

  8. COUNTERFEITING RX DRUGS • Often high-price medications • Produced “legally” in India • Packaging often made in China • Unknown components in drug • Often made in unsanitary conditions

  9. PHARMACY ROBBERIES • 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

  10. PHARMACY BURGLARIES • 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

  11. Rx Patrol • 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

  12. INTERNATIONAL SMUGGLING • 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

  13. WHAT’S THE BIG DEAL?THEY’RE JUST PRESCRIPTION DRUGS! • Elvis Presley - pain/sleeping medication • Sonny Bono - pain medication • Bret Favre - pain medication • Matthew Perry- pain medication

  14. JUVENILE DRUG DIVERSION SOURCES 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

  15. JUVENILE DRUG DIVERSION SOURCES • Parents medicine cabinet • Chronic pain patients • Garbage (fentanyl patches)

  16. DEXTROMETHORPHAN (DXM) • 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

  17. TOP Rx DRUGS OF ABUSE • 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

  18. TOP Rx DRUGS OF ABUSE • CARISOPRODOL (Soma) $3 - $4 • ALPRAZOLAM (Xanax) $3 - $4 • MEPERIDINE (Demerol) N/A (H/P Usage) • METHYLPHENIDATE (Ritalin) $10 - $12 • HYDROMORPHONE (Dilaudid) 4mg - $60

  19. OTHER SIGNIFICANT PROBLEMS • Stadol Nasal Spray • Methadone • Tramadol (Ultram) • Phentermine (Adipex) • Fentanyl patches (Duragesic/Actiq)

  20. WHY Rx DRUGS ? • Less risk of overdose • Easier to obtain through “legal” script • Cheaper than cocaine and heroin • Less risk of detection - lack of enforcement

  21. FORGED AND ALTERED PRESCRIPTIONS • Alteration of script is a felony in Ohio • Changing doses, refills or strength • White out

  22. FORGED AND ALTERED PRESCRIPTIONS • Nail polish remover • Photocopying • Computer generated prescriptions

  23. DECEPTIONS • Employee of Health Professionals • Phony call-ins • After hours “patient” scam • Doctor Shopping • Pill Brokers • ER Shopping

  24. ER DRUG SEEKERS • 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

  25. TYPICAL Rx DRUG SEEKER • 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!

  26. TYPICAL Rx DRUG SEEKER • Compliments physician • Deliberately mispronounces drug name • Agitated when cut off drugs of choice • Threatens lawsuit • Leaves abruptly when scam does not work

  27. DEALING WITH THE SUSPECTED DIVERTER • 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!

  28. DEALING WITH THE SUSPECTED DIVERTER • 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

  29. WHY GET INVOLVED? • 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

  30. DRUG DIVERSION VS. PAIN MANAGEMENT • 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

  31. QUESTIONS?

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