OVERDOSE DEATHS RISE IN JEFFERSON

Police Recruit Pharmacists, Physicians To Help Recognize And Prevent
Prescription Drug Fraud

So far this year, more people in Jefferson County have died from
prescription drug overdoses than in homicides.

Through July, 28 people died in homicide cases. But 36 people died during
that period from accidentally overdosing on prescription drugs such as
OxyContin and hydrocodone. Taken correctly, the pills are powerful
painkillers, but when abused they produce intense rushes that can stop a
person's heart.

"Homicides get publicized," said Jefferson County Deputy Coroner R.D.
Jones. "Overdoses, whether accident or intentional, they don't get publicized."

Officials with the coroner's office said they've seen an increase in the
past two years in deaths from prescription overdoses, though precise
numbers for past years aren't available because the office is just now
becoming computerized. Statistics for August and September aren't available
because toxicology tests have not been completed.

The increase in fatal overdoses highlights a problem police said they've
been dealing with for years. And their fear is that until all pharmacists
and doctors understand how to recognize and stop prescription drug fraud,
the number of overdoses will only grow.

The issue became front-page news two weeks ago when Oldham County
authorities released information about a 19-year-old man who died at a
party after taking OxyContin that had been stolen from a Jefferson County
pharmacy.

"How many more deaths do we have to have?" said Sgt. Bill Stivers, who
oversees the Louisville Metro Police drug diversion unit. "Isn't one too
many? These aren't just pills, these are controlled substances killing people."

So far this year, Stivers' squad has arrested more than 215 people on
charges related to prescription drug fraud, accusing them of posing as
doctors, burglarizing pharmacies and stealing blank pads of green
prescription forms.

In an attempt to stem the illegal use of prescription drugs, Louisville
police said they must couple enforcement with more education on what
pharmacists and physicians should look for to recognize drug fraud.

"We're no longer chasing the cocaine dealer, the crack user," said Stivers.
"What we're chasing now is a little green piece of paper" - the
state-mandated prescription form for controlled substances.

"We can stop this. We have to do it by educating people to the scams,
educating people to the fraud," Stivers said.

Police said the people accused of prescription drug fraud come from many
walks of life, but have a common trait: They'll do whatever it takes to get
a bottle of legal medications that they divert for illicit use or that they
sell on the street for a profit.

Court records reveal what authorities described as enterprising criminals:

A Louisville mother was arrested after allegedly filling her OxyContin
prescription and sending her son to sell the painkillers on the street for
$5 a pill.

A pharmacy technician at a local Kroger store told police he stole as many
as 40,000 pills in several months, using some and selling others. He is
facing charges in the case.

Another man was arrested after calling in false prescriptions for himself
from a hospital pay phone so that caller ID at the pharmacy would show the
call was coming from a hospital.

Earlier this week, pharmacist Scotty Sears of Scotty's Pharmacy at 719 W.
Ashland Ave. told Louisville Metro Police of a woman who recently tried to
doctor her prescription by increasing the quantity.

Sears said he has seen fraudulent prescriptions at his pharmacy before and
now analyzes every new prescription for a controlled substance.

"Some people are always trying to get by with something," said Sears.

Anti-fraud education

Increasingly, physicians and pharmacists are working with police to try to
stem prescription drug fraud.

Stivers presents seminars on the scams involved in prescription fraud, and
the police department has created a brochure full of "red flags" physicians
and pharmacists can look for.

Police receive reports regularly about suspicious prescriptions that are
called in or about forged prescription forms.

What worries Stivers is that he and his officers are busy every day
tracking prescription fraud despite promoting the education program for
physicians and pharmacists.

"We can literally work 24 hours a day and not be caught up," Stivers said.

If more physicians were more skeptical about requests for drugs and
pharmacists were more careful about scrutinizing prescription forms, police
said there'd be less abuse.

Dr. Mohana Arla, a Bullitt County physician, has taken the advice from the
police to heart. He knows the "red flags" police preach, rattling them off
and explaining how he has had to deal with people who want drugs but don't
need them.

"You can sense it in no time," said Arla. "There are quite a few people
seeking drugs. They make you feel bad sometimes, they make you mad. They
will make your life miserable if you don't give it to them."

Regardless, Arla and his associates have created a strict policy that no
one receives a prescription for medication unless there's an office visit
first. And even then, Arla said, there's no guarantee drugs will be prescribed.

Some pharmacies have also taken steps to cut down on fraud.

After an armed man who only wanted OxyContin robbed Sears at Scotty's
Pharmacy in May, he changed his business policy on the potent painkiller.
Walk into Scotty's Pharmacy now and there's a bright yellow sign with thick
black letters the door: "Pharmacy does not stock OxyContin."

Each time Sears sees a new prescription for a controlled substance he
analyzes it carefully. "I think pharmacists take pride in trying to catch
people. You don't want to be seen as someone who will fill any prescription
that passes by you. It gives you a good feeling keeping someone from
breaking the law."

Authorities in Madison, Ind., arrested a 44-year-old man earlier this month
in connection with a holdup at a pharmacy there. He was seeking OxyContin
and other drugs, according to Chief Bob Wolf of the Madison Police
Department. Sears said police notified him that the suspect might have been
responsible for his holdup.

Pharmacists, as well as doctors, have to make judgments when it comes to
filling prescriptions, trying to understand which patients have legitimate
needs and which want to use the drug illegally.

Sometimes, making that judgment can be challenging, said Susan Winckler,
vice president for policies and communication for the American Pharmacists
Association.

"Part of the profession's responsibility is to make sure people who need
medication are getting it and also protect against diversion," said
Winckler in a telephone interview from her Washington, D.C., office. "We're
trying to make sure pharmacists are educated on both sides."

More scrutiny needed

While some doctors and pharmacists are taking pains to help stem drug
fraud, many aren't listening to police.

Nevell Dawson, a certified drug and alcohol abuse counselor, sees the
results of that. "It's not going to get any better until screening policies
of the system are better. There needs to be more policing."

That's what Stivers and his four detectives are trying to tell physicians
and pharmacists and other medical personnel.

Louisville is among a relatively small number of communities that have a
full-time drug diversion squad to address prescription fraud, said Charlie
Cichon, president of the National Association of Drug Diversion Investigators.

The problem is, Cichon said, that prescription drug fraud only gets
attention when there's a death. For the most part, investigators and
counselors agree, there's a misconception among abusers and others that
prescription drugs are safer than illicit narcotics.

"They don't see them in the same light as doing cocaine or shooting
heroin," said Detective John Lewis, a member of Stivers' drug diversion squad.

Dawson sees that attitude in some of the people he treats.

"I think the public has bought more into 'If a doctor prescribes it, it
makes it OK, it's safe,'" the counselor said. "I'll have a patient come in
and say his wife is screaming and hollering because he smokes marijuana and
he'll say, 'She doesn't have a problem eating four or five Valium a day.'"

The medications themselves aren't bad. They're legal and often used to
provide relief from such things as pain or depression. It's when people use
them for illicit purposes that the medications present a problem, experts said.

When someone takes OxyContin legally, it serves as a time-release
painkiller for cancer and other illnesses. When it's used for illicit
purposes, it can be as strong as pure heroin in the system, authorities said.

"People feel they are safe drugs, they're not made in the bathtub, that
they're legitimate drugs," Stivers said. "But they are illegally put in the
illicit category. There are controls in place. If people would adhere to
them, it would stop this."