PHARMACEUTICAL FRAUD ON THE RISE

Fayetteville police say they are investigating more cases of diversion
- - the illegal distribution or abuse of prescription drugs - than ever.

On Jan. 14, a Willow Springs woman was charged with illegally
distributing Percocet, Tylenol with codeine and Xanax. According to
law enforcement, she was selling the drugs from a vacant home on the
3400 block of Regiment Drive. A search of the home found 21 doses of
Percocet, 24 doses of Tylenol with codeine and 300 doses of Xanax.

A day before that arrest, a Garland woman was charged with trying to
obtain Xanax from Cape Fear Discount Drug Co. with an altered
prescription. Since the drugs are legal with prescriptions, abusers or
sellers may feel they are less likely to be caught, police said. A
person often has to be caught with an inordinate amount of a drug
while committing some other crime or be referred to police by
pharmacists who notice something suspicious about a
prescription.

Other abusers may go "doctor shopping" - a process in which they visit
several doctors to obtain multiple prescriptions. Some buy the drugs
from illegal Internet pharmacies.

The drugs themselves can be resold for between $5 and $75 per dose,
depending on the pill, according to government agencies. Fayetteville
police Detective Sheila Valdez has seen countless schemes to obtain
prescription drugs illegally.

She said she knows of instances in which carloads of people travel
from pharmacy to pharmacy filling fraudulent prescriptions. They have
learned to stagger their visits and can often go undetected, she said.
Other times, an individual may alter a number on his prescription to
increase the dosage or steal prescription pads to forge his own. The
National Drug Intelligence Center, part of the U.S. Department of
Justice, said in its threat assessment for 2009 that diversion is "a
significant concern for law enforcement officials and treatment
providers nationwide." On its Web site, the U.S. Drug Enforcement
Administration says, "The illegal distribution and abuse of controlled
pharmaceuticals is widespread throughout North Carolina. Their appeal
is simply due to the relative ease of acquisition and application."
According to police, Fayetteville's 38 pharmacies make the city an
especially attractive destination for those trying to use fraud or
forgery to obtain addictive prescription drugs.

Valdez said the city has become a favorite target for addicts and drug
dealers across the Cape Fear region looking to add to their supplies
of Percocet, Xanax, Vicoden and other drugs used to treat pain,
depression or anxiety. She said there is little law enforcement can do
before someone attempts to buy the drugs with a forged or altered
prescription. Still, Valdez said her workload has nearly doubled since
she started investigating the crimes in July 2006.

The crime crosses all social and economic lines, she said. "I've
arrested 18-year-olds. I've arrested 73-year-old preachers," she said.
According to a National Household Survey on Drug Abuse, as reported by
the National Drug Intelligence Center in 2006, an estimated 36 million
U.S. residents age 12 and older abused prescription drugs at least
once in their life. A growing problem Valdez said it wasn't until a
few years ago that Fayetteville police began to grasp the problem.

That's when narcotics officers started finding prescription medicine
alongside illicit drugs during busts, Valdez said.

While cocaine and marijuana are still king among the city's illegal
drug trade, prescription drugs are on the rise, Valdez said. "It's
getting there." Valdez said she investigated more than 70 cases last
year and received several hundred tips. Department-wide numbers were
not available. Fred Eckel, director of the N.C. Association of
Pharmacists, said the problem is not unique to Fayetteville.

"This is more than a state problem. This crosses state lines," he
said. Jay Campbell, executive director of the state Board of Pharmacy,
agreed. "It's a nationwide problem, and it's always been a significant
problem," he said. "But there is clearly more attention being paid to
the issue." Campbell also teaches classes on pharmacy law at the
University of North Carolina at Chapel Hill and at Wingate University.
He travels the state to speak to pharmacy groups on the subject.

He said pharmacists are constantly taught to be on the lookout for
prescription drug crimes and often take continuing education courses
to keep up with developments.

Pharmacists are told to mark on a prescription they suspect is fake if
they doubt its veracity.

They've also begun asking doctors to write out numbers and are on the
lookout for eraser marks, multiple handwritings and ink that doesn't
appear to match. Insurance fraud Prescription drug crimes also do more
than present a headache for law enforcement. According to the
Coalition Against Insurance Fraud, insurance fraud perpetrated during
the crimes costs insurance companies up to $72.5 billion annually.

The group said a typical person who shops for doctors can cost
insurers between $10,000 and $15,000 each year.

The National Drug Intelligence Center reports that while diversion has
become more common, so has overdose deaths from prescriptions such as
oxycodone, hydrocodone, methadone and morphine.

In the 2009 assessment, the center reports that deaths from those
prescription pain relievers increased 66 percent from 2001 to 2005,
the latest year data is available.

Those deaths outpaced increases in deaths from illicit drugs, the
center said. Campbell said he thinks pharmacists have done a good job
of catching the illegal activity, but he said it's difficult to
balance the role of watchdog with care provider.

"I think pharmacists do a good job at spotting forgeries," he said.
"But we can't assume everyone should be treated as a criminal."
Campbell said a statewide reporting system where pharmacists input
prescription data on a biweekly basis has helped some instances of
diversion. As of late 2008, 38 states have legislated similar
databases. Pharmacists can check the database to see if a customer has
filled a prescription for the same drug recently or has been receiving
an inordinate amount of the drug.

"It's not a perfect system but it's a useful tool," he said.