Pubdate: Sun, 15 May 2005 Source: Johnson City Press (TN) Copyright: 2005 Johnson City Press Contact: http://www.johnsoncitypress.com/ Details: http://www.mapinc.org/media/1983 Author: Kristen Swing Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) Prescription Drug Fraud A NEW FRONT IN WAR ON DRUGS Hard-core illegal drugs are apparently losing their appeal as many new addicts turn to prescription drugs to get their highs. "Lortab, Percocet and OxyContin are the main ones people are trying to get," said Dr. E.C. Goulding III, director of emergency medicine at North Side Hospital, Indian Path Medical Center and Sycamore Shoals Hospital. "They're narcotics that can give someone a euphoria effect. It gives them a little high all the time, just a feeling like they had a lot of alcohol." The use of these legal narcotics is making the war on drugs a more difficult battle to fight, according to local law enforcement. "If it's an illegal drug, it's obvious that they're not supposed to have it. If it's there, you know it's illegal," said Capt. Mike Street, commander of the Johnson City Police Department's Criminal Investigations Department. "But with these drugs there may be a legitimate reason for a person having it." With drug abusers reaching for pills found in little orange bottles behind the counters of local pharmacies, the battle against drugs has been forced to recruit soldiers from outside the law enforcement realm to combat the problem. "The doctors and the pharmacists, they're the victims of it," Street said. "I think the majority of them in the area are really good with cooperating with us. They are trying to do everything they can do." Pharmacists and doctors are doing their best in trying to eliminate drug abuse despite facing obstacles in their fields that weren't always so common. "It's always been a problem since I've been in practice. It's just grown since then; it's a lot more common," said Pat Rowan, a pharmacist at Boones Creek Pharmacy who has been in the field for the last 28 years. "Apparently they have found a way that they feel is relatively easy to get controlled substances." Instead of resorting to breaking into or robbing pharmacies, prescription drug abusers, often called 'pillheads,' are using a variety of fraudulent methods to get their hands on drugs like Lortab and Percocet. Getting The Goods According to health professionals like Wayne Copp, a pharmacist at Blankenship Pharmacy, there are four major methods people are using on a regular basis to fraudulently obtain narcotics. "First, you've got valid subscriptions that are being obtained that are not being used by that person," Copp said. "Part of that market out there is you've got a person with a legal prescription for a drug that is legal to dispense, then they're going to go out and sell it -- and that's the only part that is illegal. It's difficult." It is nearly impossible for a pharmacist to determine who gets a legitimate prescription filled only to go out and sell the medication, he added. "Then you've got people who get a legit prescription and then attempt to alter it in some way," Copp said of the second method used to get controlled substances. In late March, a man tested this method at Blankenship Pharmacy when he passed an altered prescription at the drive-through. The individual reportedly altered the prescription from its original 50 milligrams of Indocin, an anti-inflammatory drug, to 5.0 milligrams of Endocet, a pain medication. While this individual was arrested and charged for the crime, others do go unnoticed, Copp said. "I think it's kind of scary that we don't really know how many get by us," he said. Some addicts take altering prescriptions a step further by stealing blank prescription pads from a hospital or doctor's office, leaving the drug abuser with a blank slate for controlled substance desires. "We try to keep them locked up in the ER or an office, but we have had prescription pads stolen from the ERs," Goulding said. "We do our best to prosecute these people." In early May, police discovered a stolen prescription pad had served up nearly 500 pills of 40-milligram OxyContin to fraudulent users in the area. "Somebody had stolen a (prescription) pad of a doctor from Kingsport and they floated those things all over Johnson City," Street said. The fake prescriptions were used at a variety of local pharmacies. "It's not isolated," Street said. "They'll start at one pharmacy and they'll just keep going. They'll just go in a circuit in a real short period of time." While doctors are on the lookout for people trying to steal prescription pads, it appears that many addicts choose to get their fill of prescription drugs without ever seeing a physician -- all with the convenient help of a telephone. "The most common way is people will pose as a nurse and call in a prescription for a patient," Rowan said. "We have seen more fraudulent phone instances than phony prescriptions." Pharmacists can, and often do, check up on suspected instances of false prescriptions, whether written or phoned in, but addicts aren't making it easy. "What they'll do is forge the prescription and come in at 5:30 when the doctor's office is closed," Rowan said. "Then you have to make a judgment call and decide if it's a good prescription. It's hard because if it is good, you don't want the person to go without." A similar concern faces doctors, who must determine whether a patient is experiencing legitimate symptoms of a disease or if he or she is simply trying to get high. "We do have them coming in feigning injuries to get drugs," said Goulding, who estimated they see 10 to 15 instances of someone faking symptoms to get narcotics each month. In late April, a woman went to the North Side Hospital emergency room seeking treatment but reportedly gave personnel false information in order to get a prescription for a controlled substance. After examining the woman, doctors suspected she was lying. "We try to find consistency in what they report happened and what the physical exam shows," Goulding said. Last Thursday another woman was arrested for the same crime after she gave medical personnel false information and even tried to taint a medical test in order to get a prescription for pain medication. In early May another incident occurred involving two local hospitals. A Mountain City man arrived first at Johnson City Medical Center to receive treatment for his injured hand. After receiving a prescription for pain medicine and having it filled, the man then reported to North Side, where he was treated for the same injury and received another prescription for the same pain medication. Health institutes are now working together to decrease the number of such instances that might go unnoticed. "We are able now to look at a computer to see how many times a person has been to any of the five hospitals (of Mountain States Health Alliance)," Goulding said. Goulding often asks patients when they last went to a hospital and if their claim doesn't match up to what the computer shows, it's a good indication that something isn't right, he said. Cracking down on "pillheads" Another issue making it difficult to eliminate or decrease illegal use of prescription drugs stems from the people doing the abusing of these drugs. "With this type of crime, it's so widespread among different classes that it affects people everywhere," said JCPD Lt. Matt Howell. "There have been many professional people that we've arrested." Despite the difficulties facing the fight against controlled substance abuse, health professionals and law enforcement agencies are working hard to crack down on the number of people that get away with narcotics fraud. "We are doing better at fighting this," Goulding said. "I think the more aggressive the pharmacists, physicians and law enforcement get with this, the less it's going to happen." And while prescription drug abuse has been an existing issue for decades, the perspective of health professionals has changed over the years, leaving this type of drug addict with less room for error. "It used to be that if I suspected it, I'd tear up the prescription and tell them not to come into the store again. Usually that would take care of it," Copp said. "Now, I just sense that we've got to let people know that it's really risky to try that here." Doctors are also emphasizing the legal ramifications for prescription fraud and controlled substance abuse. "There's more than just a slap on the hand involved in this," Goulding said. "You can go to jail." - --- MAP posted-by: Elizabeth Wehrman