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More Americans Popping Pain-Killers

Detective describes County’s efforts to stop surge in abuse of pharmaceuticals.

What would you do if you found a crack-pipe in a friend’s medicine cabinet? Be concerned, at the very least.

What would you do if you found a bottle of pain-killers in your friend’s medicine cabinet? The answer is murkier. If your friend just had a root-canal, or threw out her back the week before, you probably don’t give the bottle another thought.

But although millions of Americans take legally prescribed pain medication for acute or chronic conditions, millions are also illegally abusing it, often because of an addiction.

Detective Robert Urps, a Mount Vernon native and now a Fairfax County drug diversion detective, described the growing problem of prescription drug abuse at the Mount Vernon Citizen’s Advisory Council meeting on May 9. Urps said that abuse of prescription medications doubled between 1992 and 2003, and tripled among teenagers. He said most abusers got their drugs from friends, doctors, or over the internet. “There’s no stigma involved with what people see as pain meds.” When someone asks a friend to share an extra pain-killer, giving away the pill does not have “the stigma of [saying], ‘Here’s a crack cocaine rock; go smoke up,’” Urps said.

Urps said Fairfax police used to treat prescription drug crimes in an unsystematic way, receiving people who overdosed or were caught with someone else’s prescription drugs, charging them, then releasing them with little or no investigation into where they got the drugs and whether they were repeat offenders.

But as Fairfax officers identified increasingly common patterns of abuse, they recognized that a more systematic effort was necessary in order to go after illegal pharmaceuticals like any other illicit drug. Three years ago, the Drug Diversion Investigations office was created. Drug diversion investigators began tracing the origins of the illegal drugs they found on overdose cases and during investigations. The detectives work with agents of the Drug Enforcement Administration, the FBI, and the Food and Drug Administration – all federal agencies with a stake in the regulation of prescription drugs and enforcement of the laws that govern them.

RECENT high-profile admissions of prescription drug addiction, such as Patarick Kennedy’s and Rush Limbaugh’s, highlight the growing prevalence of prescription drug abuse in the United States. Estimates from the 2004 National Survey of Drug Use and Health reveal that prescription drugs are the second most common type of illicit drug behind only marijuana. But Urps stressed that people tend to view prescription drugs in a separate category from other illicit drugs. “[Users experience] the same addiction you’re going to see when it comes to marijuana, cocaine, heroin, but a lot of people don’t think its as a bad because it’s a legitimate drug, so to speak,” Urps said.

Prescription drug abuse has become as serious as the abuse of other always-illegal drugs, and the providers and procurers of these drugs have become just as sophisticated as drug dealers in other fields. “When I was on the street ten years ago,” Urps said, “usually if you searched a guy you found the heroin, marijuana, crack. Now you’re finding pills mixed in.” Instead of heroin needles, police officers are finding pill grinders.

Urps went on to describe where these illegal prescriptions are coming from. He related one common scenario: a corrupt doctor writes a patient a prescription for a fake injury. The doctor bills the insurance company for the patient’s visit. The patient uses a portion of the pain-relievers and sells the rest for a profit. “These prescription drug cases run the gamut from doctors to nurses to dentists to pharmacists,” Urps explained.

But dealers and abusers of prescription drugs do not rely on corrupt care providers. Many simply steal a blank prescription pad, write their own prescription and present the phony scrip to pharmacies. Urps said forged prescriptions can be identified in a variety of ways. Orders for unusually large amounts of drugs are one tip-off. If the prescription is obviously photocopied, or if its edges are uneven (from using a paper cutter to chop up photocopies) this should set off alarms. And if the handwriting on the prescription is legible, it obviously wasn’t written by a doctor.

A clever forger will copy the name and number of a real doctor, but change the phone number, sometimes simply giving the number of a payphone near the pharmacy she plans to visit. An accomplice will wait by the phone when the forger enters the pharmacy then answer any call as if he were a receptionist at the doctor’s office.

Urps advised the audience members to shred all of their own prescriptions after using them. Fishing for prescription notes that have been carelessly thrown away is one of the simplest ways to illegally acquire prescription drugs.

“THERE is no typical RX suspect,” read one slide in Urps’s Power Point presentation. “Never assume the elderly are not involved in drug diversion,” Urps said.

“I locked up a guy I grew up with,” he added, describing the origins of the man’s addiction as a “legitimate accident.” The man had injured his back working in a warehouse and become addicted the pain-killers he was prescribed.

Urps described another recently-arrested woman who had used 20 different names, four doctors, and visited pharmacies on Route 1, and in DC and Prince George’s and Charles counties. “Long story short, we ended up locking her up with the DEA’s help. They got a federal arrest warrant for her … and in federal court the pill count on a bad scrip case is like grams of marijuana … the pills add up quick.” He mentioned that after being approached by a narcotics officer about cooperating with an investigation, the woman visited a pharmacy the next day and tried to buy pills by presented the officer’s card and claiming to be his wife. This attempt was unsuccessful.

But even for people without a physical addiction to prescription drugs, the rewards of acquiring drugs like the pain-killer Oxycontin, which Urps said was initially designed for terminally ill patients and packs as much pain-killing punch as 16 Percocets, can be irresistible. Urps said Oxycontin typically sells for 50 cents to one dollar per milligram. A single pill often costs $30 to $50.