WHEN THE WAR ON DRUGS MEETS YOUR LOCAL PHARMACY

SUMMIT COUNTY - You hear about the meth labs. You hear about the drug
task force busting up a marijuana-growing operation.

But what you rarely hear about, the new problem plaguing law
enforcement, comes from the medical community.

It's called doctor shopping. Why go to all the trouble of finding a
drug dealer, when a pharmacist can get you high?

Here's the way it works: A person has oral surgery or a back injury,
and the doctor prescribes a painkiller. Or maybe it was a friend,
innocently passing on a pill to a friend. They take one, two, run
through the bottle and then, possibly, want more.

Many analgesics are addictive. They work on the nervous system,
building up tolerance and dependence, just like their chemical cousins
obtained on the streets. The opiates in pills work just like the
opiates in heroin.

So, if an addict is going to get more, a doctor is his or her only
hope. "If taken properly for pain, that's fine," said Roy Hoff,
pharmacy manager at City Market's Breckenridge store. "But they can be
abused. Unfortunately, some of them are seen as party drugs up here.
We do see it a lot."

Hoff said he suspects Summit countians' active lifestyles contribute
to the problem. Doctors issue a lot of prescriptions for painkillers
for all the biking and skiing injuries.

How does a pharmacist tell the difference between a doctor-shopper and
a legitimate prescription?

It's not easy. First of all, pharmacists don't have a common computer
database. Hoff usually can't tell if another pharmacist has already
refused to fill a prescription or if the customer tried to use a
forged doctor's note somewhere else.

The doctor-shoppers get tricky, Hoff said. In one case, investigators
learned a customer had been to Vail and Grand Junction trying to score
before being apprehended in Summit County.

But there are tip-offs. If people give insurance information in an
effort to reduce out-of-pocket costs, they're almost always caught.
Sometimes the customer asks for a brand-name drug and wants to pay in
cash.

"That usually means they're going to sell them," Hoff said.
"Otherwise, they'd take the generic equivalent, because it's cheaper."

Pharmacists can be overly suspicious, though, says Sondra Douglas of
Keystone's Mountain View Drug.

Douglas said she has heard of customers being denied a prescription
because of doubts or fears, only to learn later the prescription was
valid.

Douglas said she herself turned someone away, only to learn later the
patient truly needed the medication after surviving a car accident and
head injury.

"I'm 62," she said. "We didn't have this problem in my generation. Now
you can take classes to learn how to recognize the problem."

Douglas said the key for pharmacists is communicating with patients
and their doctors, something that doesn't happen as often when lines
at the counter get long or pharmacists get busy.

The one thing both pharmacists agreed on: Summit County's drug task
force is helping address the problem. Douglas and Hoff have referred
cases to the task force and occasionally field questions from agents.

"They're doing a good job," Douglas said. In the end, though, it's a
health problem, Hoff said. He lamented that by the time a
doctor-shopper is discovered, the problem is well along its course.
Law enforcement has to be involved, he said, but it will take doctors
to help the patient.

"I don't know how you stop it," he said. "Many times, you're dealing
with young people who feel invulnerable to everything. Before you know
it, they have problem they physically can't deal with."

This is the final in a three-part series on Summit County's chemical
culture.