Americans consume more prescription drugs than any other country in the world. With more prescription narcotics available than ever before, prescription drug addiction is the largest growing drug problem in the country — currently exploding among teens.
The Borough of Queens is no exception, and last week’s article in our news series on the issue, showed that prescription drugs are readily available — with teens getting them from even their own parents’ medical cabinet. But the availability is not only due to over-prescribing and the circulation of unused drugs. Prescription forgeries, pharmacy robberies and black market dealing are increasing methods to acquire the drugs. And legislators and police are escalating efforts against the problem.
The past three months the State Attorney General’s Medicaid Fraud Control Unit has unraveled three rings of drug forgery operations. On April 4, four ringleaders were arrested and indicted for distributing black market prescription HIV drugs. On March 27, 52 members of a narcotics network who were distributing massive quantities of cocaine, heroin and OxyContins and other prescription medications were arrested. And in February, a female ringleader was sentenced for stealing 250 prescriptions from city hospitals and trading them in at pharmacies around town.
Queens is on the route of the Long Island Expressway, which has recently been named “Heroin Highway” by Queens District Attorney Richard Brown. Investigations in January revealed a pattern of suburban Long Islanders going to the city to buy heroin, and stopping in Queens on the way back to deal at diners, newsstands and other meeting spots.
The Drug Enforcement Agency spokesperson Erin Mulvey said the Tactical Diversion Squad found seven organizations that diverted drugs in 2000 and 143 in 2011.
Following last summer’s robbery at Haven Drugs in Medford, where David Laffer killed two employees and two customers before grabbing 8,000 hydrocodone pills for his addicted wife, the DEA raided a doctors’ office in Great Neck, known to be associated with the imprisoned couple’s hydrocodone prescriptions. In another operation they arrested a doctor from Baldwin Harbor, on Long Island, who had allegedly been prescribing oxycodone from his car.
The squad now has its eye on Queens. “Queens is right between Long Island and Manhattan with pharmacies that cater to the ones diverting illegal drugs,” Mulvey said.
The DEA reports that armed robberies at pharmacies rose 81 percent between 2006 and 2010, from 380 to 686. In New York State, the number of armed robberies rose from two in 2006 to 28 in 2010.
Rxpatrol.com, sponsored by OxyContin maker Purdue Pharma, says it has tracked 1,258 pharmacy burglaries since 2002. Neither agency has recorded prescription drug pharmacy shootings in Queens, but Queen’s pharmacists are aware of their at-risk position
Norman Hansman, the owner of Woodhaven Boulevard Pharmacy in Rego Park, was robbed several times in the past. Back then, he said, it was another popular prescription drug that attracted the robbers. Today, Hansman has installed cameras, and signs in the store and popular narcotics are hidden behind the counter.
“You are supposed to use judicial common sense. Somebody comes here with a prescription for narcotics, and they don’t look right, I don’t have it,” Hansman said. “You are trying to protect the pharmacy and yourself. Why would they come here from Staten Island or the Bronx, they don’t live here?”
Hansman said suspected prescription drug abusers come by a few times a week. “Everyone who comes here with a narcotic prescription, first of all we ask to see ID, then we call the doctor and ask them, did you write this? If they say yes, we can’t ask them why,” he said.
Bruce Snipas, the owner of B&E Pharmacy also in Rego Park, IDs and double checks with the doctor as well. Yet, he said there is still no guarantee. “I can call the prescription to the pharmacy as myself leaving my own number,” he said. “There are ways to get around it and believe me they know how to do it.”
St. John’s University College of Pharmacy and Allied Health Professions invited pharmacists to a seminar on prescription drug abuse and safety and security in the pharmacy this past February. Sheila Brocavich, assistant clinical professor at the Jamaica campus, informed participants about the various forms of prescription fraud. The first resort of many users of legally prescribed drugs who become addicted is to alter a legitimate prescription to change the type of drug, increase the number of refills, increase the quantity, or add drugs. Another tactic is to copy legitimate prescriptions for multiple uses or to phone in fraudulent prescriptions posing as an employee of a doctor’s office. Theft of prescription pads is also common. Or the person simply visits various doctors, complains about pains and collects several prescriptions, also known as “Doctor Shopping.”
“The age group more likely to obtain a fraudulent prescription or doctor shop would typically be an older person,” Sheila said. Snipas confirms this tendency at his pharmacy. The latest numbers from the Department of Health show ER visits for overdoses of opioids were reported to be the greatest among 45-to-54-year-olds followed by the 35-to-44-year-old age group.
Pharmacists are required by law to report any prescription drug diversion to the Bureau of Narcotic Enforcement. Suspected diversion includes practitioners who may be prescribing in bad faith, as well as instances when controlled substances are lost or stolen. But many pharmacies don’t always do that.
“If it’s something really important, we do it. But we try not to get involved because it’s going to require a lot of your time,” Hansman said. “We are not the FBI.”
Snipas echoed his colleague. When the DEA discovered a forgery conspiracy between a doctor from the Bronx and her patient who came to Snipas to fill her prescription, he had to daily contribute to the investigation. So he is hesitant to involve the police. Also, he says, “how do you know who is an addict and who is a criminal? It’s a difficult situation.”
The existing database is in place to monitor when and where prescriptions are being filled is DOH’s Controlled Substance Information on Dispensed Prescriptions. Its purpose is to provide prescribers of narcotic substances secure on-line access to their patients’ recent prescription history to help provide them optimal treatment and prevent over-prescribing.
It also helps pharmacists check the validity of the prescriptions. “Once I keyed it to the computer, I am prompted for the serial number. If done incorrectly, the state will notify me. They already know which numbers go with which prescription,” Snipas explained.
However, the database only displays prescriptions written within the past 30 days and because the database is not real-time, there is a 45-days delay.
To better the system, State Attorney General Eric Schneiderman has proposed the I-STOP bill, the Internet System for Tracking Over-Prescribing, that if enacted, would create a new real-time online database enabling doctors and pharmacists to report and track the prescriptions.
While Schneiderman’s proposal currently sits in the state Senate’s Health Committee, its chairman, Kemp Hannon, is pushing his own set of proposals, favored by the industry, that would reform the exisiting database and cost less to implement.
Schneiderman’s Press Secretary Jennifer Givner said that while the office doesn’t object to Hemp’s bill, they feel it is not ambitious enough. “We are continuing to work with government members of the Senate and Assembly to ensure that I-STOP is passed in the coming weeks,” she said. The AG has for months been building a bipartisan coalition of supporters from elected officials to law enforcement and healthcare experts including Sen. Andrew Lanza (R-Staten Island) and Assemblywoman Aravella Simotas (D-Astoria).
“By allowing e-prescriptions for controlled substances New York State will improve our ability to track these drugs and reduce the prevalence of prescription theft, forgery and error,” Simotas said. “This measure would add a layer of protection for small business owners while cracking down on addicts and those who enable them.”