Pubdate: Mon, 28 Oct 2002 Source: Greenville News (SC) Copyright: 2002 The Greenville News Contact: http://greenvillenews.com/ Details: http://www.mapinc.org/media/877 Author: Liv Osby MORE SENIOR CITIZENS CAUGHT SELLING PRESCRIPTIONS When police in Spartanburg set up a stakeout to catch a neighborhood drug dealer, the last person they expected to see passing pills was someone who looked like their grandmother. But when a tiny, gray-haired 75-year-old woman took cash in exchange for her prescription drugs, they were forced to bring her in and charge her with unlawful distribution. "She was getting methadone, Lortab and Valium and selling those drugs ... to supplement her income," said Kaushik Kotecha, Piedmont district director of the state Department of Health and Environmental Control's Bureau of Drug Control. "You don't expect to see an older person like a grandmother selling it." The average age of those arrested for illegal distribution of prescription drugs, also known as drug diversion, is still closer to Hollywood's image - -- someone in his 40s, said bureau director Wilbur Harling. In the fiscal year that ended June 30, 2001, the bureau made 420 arrests, 10 of them involving people age 58 to 63, Harling said. The following year, there were 341 arrests, with 16 of the suspects between 56 and 71. So far this fiscal year, which began July 1, 121 arrests have involved five people 57 to 75. With the increasing popularity on the street of painkillers such as Percodan and oxycodone, Didrex and other weight-loss amphetamines, and anti-anxiety drugs such as Valium, Xanax and Ativan, drug diversion is a growing crime. The federal Drug Enforcement Administration estimates that a third of all prescription drugs are sold this way, Kotecha said. "People think of marijuana, cocaine, crack, the typical illegal drugs, but this is something just as bad," said Lt. Mike Gambrell, spokesman for the Greenville Police Department. Spartanburg Lt. Bill Michels described the 75-year-old woman as "pretty close to the oldest person I've ever arrested. "In a case like hers, it was more for need than greed," Michels said. "She said it more than one time that she did not have enough to live on." It underscores the economic pressures that senior citizens face, said Patrick Cobb, spokesman for the South Carolina chapter of AARP. "They're forced to split pills, to choose between getting drugs (and) ... determine how to pay for food, clothing and shelter." "Some of the elderly are caught in a pinch, and I've heard of people that have to choose which prescriptions they're going to get filled this month," said Brooks Metts, associate professor of pharmacy at the University of South Carolina. Sometimes sickly older people get involved when drug dealers use them as fronts to get medication, said Cheri Crowley, supervisor with the DEA's diversion group in Columbia. "They'll gather them up, take them to the doctor's office and take the drugs to sell," she said. And elderly people in nursing homes, hospice care and home health care also are targets of health-care workers or relatives who divert their drugs, said Charlie Cichon, president of the National Association of Drug Diversion Investigators. Crowley's division arrested two senior citizens in the past year for diversion -- a 69-year-old woman charged with selling the painkiller oxycodone and a 64-year-old man who was selling OxyContin, Percocet, Percodan and Tylox. But while some are in it for the money, others do it to satisfy their addiction. "Oftentimes they're abusing drugs, as well as selling," said Crowley. "And unfortunately, it's been their lifestyle or a family member's lifestyle that they've taken up not because they're having financial difficulties." Because it so often goes undetected, diversion could make up more than 50 percent of illegal drug trafficking, said Deputy Sheriff Steven Siske, who works diversion with Asheville's Metropolitan Enforcement Group and trains law enforcement and health-care professionals about the crime. "The reason is the time it takes to work one case, unlike a quick drug buy," Siske said. "A lot of agencies don't have the manpower to keep up on it, and the criminals know that. So there's a tremendous amount that goes undetected." And because they typically aren't thought of in the role of drug dealer, some say the elderly may be the least detected drug diverters of all. One of the more widely used methods of illegally obtaining prescription drugs is "doctor-shopping" -- going from one doctor to another with a complaint, such as pain, Siske said. Authorities rely heavily on pharmacists and physicians to report these crimes, Siske said, and pharmacists typically finger doctor-shoppers. "Once they verify that Jane Doe has been to 15 different doctors, they can report that," he said, "and when they see forged or suspicious prescriptions." Call-in fraud, where someone pretending to be from a physician's office telephones a prescription to a pharmacy, is increasingly used as well. "I'm getting ready to indict a registered nurse in federal court who had obtained almost 10,000 (pills) by picking up the phone." The disabled make up another surprising group of diverters, said Kotecha. A disabled woman in Laurens County, for example, was arrested and charged with trading her OxyContin for all-terrain vehicles, which she then sold, he said. And a disabled man, also from Laurens County, was getting the same painkiller from two doctors, keeping one and selling the other for $50 a pill. "He was making $4,000 to $5,000 a month," Kotecha said. He said conviction carries a penalty of five to 25 years in prison. Supply and demand is at the heart of diversion, Heit said. "If there's a demand for a particular product, such as an opioid medication, there are people who will be willing to break the law to traffic and divert these medications for profit," he said. High-profile cases, such as the OxyContin diversions in the past couple of years, have generated fear among physicians that may translate into inadequate treatment for patients with real pain, said Dr. Marc Hahn, president of the American Academy of Pain Medicine. That, in turn, can lead to depression and suicide. "Anybody who treats pain has several patients who have either tried to commit suicide or contemplated it," said Greenville psychiatrist Dr. Patrick Mullen. Said Hahn: "It's difficult because of the abuse potential of some medications. But doctors need to be sensitive. Appropriate care of patients in pain is an education process for physicians, the public and regulatory agencies." - --- MAP posted-by: Larry Stevens