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“Drug Diversion-The Scope of the Problem” Teleconference Commander John J. Burke

“Drug Diversion-The Scope of the Problem” Teleconference Commander John J. Burke. PHARMACEUTICAL DIVERSION. Commander, Warren County Drug TF (1999-Present) Coordinator- Southern Ohio HIDTA Pharmaceutical Diversion Initiative

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“Drug Diversion-The Scope of the Problem” Teleconference Commander John J. Burke

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  1. “Drug Diversion-The Scope of the Problem” Teleconference Commander John J. Burke

  2. PHARMACEUTICAL DIVERSION • Commander, Warren County Drug TF (1999-Present) • Coordinator- Southern Ohio HIDTA Pharmaceutical Diversion Initiative • Vice President- National Association of Drug Diversion Investigators (NADDI)(1996-Present) • President- PDE Inc. (1995-Present) • 32 years Cincinnati Police Division (1968-1999) • Commander Pharmaceutical Diversion Squad (1990-1999)

  3. PHARMACEUTICAL DIVERSION • Developed in 1990 • Average 500 cases a year • Average 250 arrests a year • Investigate illegal diversion of Rx drugs • Investigate health care fraud

  4. SCOPE OF THE PROBLEM • Almost 30% of the overall drug problem in America • Ranks second only to marijuana • #1 drugs of abuse over the last 30 years

  5. SCOPE OF THE PROBLEM 2003 SAMHSA Survey Results: • 6.2 million people abused Rx drugs in the last year • Significant rise in Rx abuse for those 12-17 years of age

  6. 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

  7. VICTIMLESS CRIME? • Andrew Cunanan - pain medication • Nevada Casino Incident - Dexedrine • HP Abuse/Patient Care - pain medication

  8. TOP Rx DRUGS OF ABUSE 1. HYDROCODONE (Vicodin, Lortab, Lorcet) $6 - $8 2. OXYCODONE (Percocet, Percodan, Tylox) $6- $8 (OxyContin $.50-1.00 mg.) 3. ACETAMINOPHEN WITH CODEINE (Tylenol #3, Tylenol #4) $3 - $5 4. BENZODIAZEPINES (Xanax/Valium) $1 - $4 5. PROPOXYPHENE (Darvon, Darvocet) $2 - $4

  9. TOP Rx DRUGS OF ABUSE 6. CARISOPRODOL (Soma) $3 - $4 7. MORPHINE SULFATE (MS Contin) 100mg - $60; 60mg - $45; 30mg - $30 9. MEPERIDINE (Demerol) N/A (H/P Usage) 10. METHYLPHENIDATE (Ritalin) $10 - $12 11. HYDROMORPHONE (Dilaudid) 4mg - $60

  10. OTHER SIGNIFICANT PROBLEMS 1. Stadol Nasal Spray 2. Proventil 3. Ultram 4. Methadone 5. Fentanyl patches

  11. DRUG DIVERSION SOURCES • Forged/Altered Prescriptions • “Doctor Shopping” • Other Rx Scams • Internet

  12. DRUG DIVERSION SOURCES • Reverse Distributors • Health Professional Diversion • Package Interdiction • International Smuggling

  13. 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

  14. FORGED AND ALTERED PRESCRIPTIONS • Alteration of prescription • Changing doses, refills or strength • White out

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

  16. DECEPTIONS • Doctor shopping/ER shopping • Phony call-ins • After hours patient scam • Employee of health professionals

  17. WHAT CONSTITUTES DECEPTION ? • Patient gives false name and address to obtain drugs • Patient gives fictitious story to obtain drugs (out of town) • Patient lies about ailment or injury • Patient denies seeing any other doctors and obtaining any other Rx drugs

  18. 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!

  19. PHARMACY COLLABORATION • Communicate regularly with local physicians • Understand and discuss your concerns • Encourage doctors to make you part of the pain management team

  20. 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

  21. Rx Patrol • Nationwide Law Enforcement Database • Invented & Funded by Purdue Pharma • Pharmacy Robbery & Burglary Offenses • Networking Opportunities for LE

  22. Rx Patrol RX PATROL PARTNERS • National Association of Drug Diversion Investigators (NADDI) • National Community Pharmacist’s Association (NCPA) • National Association of Chain Drug Stores (NACDS) • Pharmaceutical Security Institute

  23. Rx Patrol • Reporting necessary by LE &/or pharmacists • www.rxpatrol.org • Database compares like/similar offenses • LE agencies contacted if possible match occurs

  24. PRESCRIBING PRACTICES • This program is NOT intended to discourage the dispensing of appropriate medication for legitimate medical purposes

  25. PRESCRIBING PRACTICES • Legitimate patients with pain should not suffer because health professionals are fearful of law enforcement • Law enforcement is not interested in investigating appropriate dispensing of Rx drugs

  26. PRESCRIBING PRACTICES • Its important that none of us allow those who divert prescription drugs to influence the legitimate prescribing and dispensing of controlled substances

  27. METHAMPHETAMINE AND THE RETAIL PHARMACY

  28. Methamphetamine • Schedule II. Current accepted medical use, high potential for abuse. • Can be manufactured using material bought in Wal-Mart. • National rapidly emerging drug problem. • Methods of use: • Snorting • Smoking • Injecting • Eating • Drinking

  29. Effects: Increased heart rate Irregular heartbeat Increased blood pressure Irreversible damage to blood vessels in the brain, producing strokes. Respiratory problems Anorexia Cardiovascular collapse Death Central Nervous System Effects: Irritability Confusion Paranoia Convulsions Hyperthermia Insomnia Tremors Aggressiveness Anxiety Convulsions Methamphetamine

  30. Methamphetamine

  31. Indications of Meth Lab Activity • Strong chemical smell (ether/ammonia) • Efforts made to cover windows or reinforce doors • Trash never put out; always burned • Considerable late night hour traffic • Lab materials surrounding property (fuel cans/chemically stained coffee filters/altered propane tanks)

  32. Indications of Meth Lab Activity • Suspicious vehicles arriving with trunks/chemical containers and paraphernalia/rubber tubing, etc. • Occupants always smoking outside • Paranoid behavior of residents or extensive security

  33. How Meth is Made • Made with common household products sold in pharmacies everywhere • Cold tablets containing Ephedrine/Pseudoephedrine • Ether (Starting Fluid) • Sulfuric Acid (Drain Cleaner)

  34. How Meth is Made • Methanol/Alcohol (Gasoline Additives-Heet) • Salt • Lithium (batteries) * Hundreds of recipes on internet

  35. How Meth is Made Anhydrous Ammonia (Farm Fertilizer) • Stolen (farmers, retail distributors) • Stored in altered propane tanks -bluish color at valve on tank

  36. Equipment used to Manufacture Meth: • Mason Jars and Pyrex dishes • Bottles, funnels, coffee filters • Blenders, hot plates, rubber gloves

  37. PHARMACEUTICAL DIVERSION EDUCATION INC. John J. Burke, President P.O. Box 146 Bethel, Ohio 45106 1-800-566-2049 (Office) 1-513-734-1647 (Fax) www.rxdiversion.com Email: burke@rxdiversion.com

  38. Questions?

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