WARREN COUNTY DRUG TASK FORCE RX DRUG ABUSE PROBLEM FROM LAW ENFORCEMENT PERSPECTIVE

WARREN COUNTY DRUG TASK FORCE DETECTIVE DENNIS M. LUKEN P.O. Box 898 Lebanon, OH 45036 Phone 513-336-0070 Fax 513-336-9097 Cell 513-623-0663 Website: www.wcdtf.org Email: luken@wcdtf.org

PHARMACEUTICAL DIVERSION EXPERIENCE Detective with the Warren County Drug Task Force since 2001 Treasurer for the National Association of Drug Diversion Investigators (NADDI) 2000-2007 25½ years Cincinnati Police Division Investigator with Pharmaceutical Diversion Squad – 4½ years Over 13 years experience conducting pharmaceutical drug diversion and healthcare fraud investigations

WARREN COUNTY DRUG TASK FORCE Actually formed in early 1990’s Four years ago became the Southwest Ohio HIDTA initiative called SWORD Currently there are 17 members assigned to the task force including a pharmaceutical diversion investigator and drug interdiction deputy with his canine “Kilo”

WARREN COUNTY DRUG TASK FORCE WCSO, DEA, ATF, FBI, Ohio BCI & I, Lebanon Police Department, Wilmington Police Department, Ohio National Guard (intelligence analyst) Investigate mid to upper level drug traffickers that ultimately lead us to the Southwest border states in an attempt to reach the ultimate supplier of drugs that come into the United States from Mexico

WARREN COUNTY DRUG TASK FORCE Educate the community about the illicit drug problem as well as the epidemic prescription drug problem Educate health professionals how deter prescription drug abuse Propose and actively secure the passage of legislation to fund and combat the drug problem in Ohio

SCOPE OF THE PROBLEM Rx drug abuse comprises over 50% of the overall drug problem in America Ranks close second to marijuana Rx drugs have surpassed marijuana as drug of choice for new users

Even Barbie Chemically Copes

SCOPE OF THE PROBLEM Most likely drug to be abused in the workplace Obtain through insurance “Only prescription drugs”

SCOPE OF THE PROBLEM 2000 SAMHSA Survey: 3.9 million people abused Rx drugs in the last year 2.1 million people abused cocaine and heroin combined

SCOPE OF THE PROBLEM 2003 SAMHSA Survey: 6.2 million people abused prescription drugs last year 1.4 million abusers were between the ages of 12-17

SCOPE OF THE PROBLEM Prescription drugs now play a factor in one quarter of all overdose deaths reported in the United States Since 1995, the number of Ritalin prescriptions have quadrupled “Pharming”, “bowling”, and “trail mixing”

SCOPE OF THE PROBLEM From 1999 to 2007, the death rate due to unintentional poisoning has increased more than 300% in Ohio Nearly all (96%) of these deaths are due to drugs and medications, and are largely driven by prescription drug over doses Ohio Department of Health (ODH)

HEALTH CARE FRAUD According to “Prescription for Peril” (Mahon) Opioid abusers cost healthcare insurers $15,884 per year per patient (2005) Non-abusers cost insurers $1,830 per year Over 8 times higher than non-abusers $72.5 billion in fraud in the abuse of opioids

METHODS OF DIVERSION Doctor shopping/ER Shopping Phony call-in prescriptions Forged and fraudulent prescriptions Diversion and theft from healthcare facilities (hospitals, nursing homes, pharmacies) Internet diversion

INTERNET DIVERSION According to ONDCP – Identified 34 rogue internet pharmacies in 2006 Dispersed over 98 million dosages of hydrocodone Would take 1,118 average pharmacies to equal amount dispensed by the 34 illegal internet apothecaries

TOP DOCTOR SHOPPER AWARD Total of 355 prescriptions Over 100 different doctors Over 100 different pharmacies Received 7,617 doses of tramadol Received 8,496ml of hydrocodone based cough syrup Received 2,799 doses of hydrocodone

PRESCRIPTION MONITORING PROGRAMS (PMP) STATE OF OHIO Ohio Automated Rx Reporting System (OARRS) is operated by the State of Ohio Board of Pharmacy Contains all prescriptions for controlled substances and Ultram and Soma filled by pharmacies in the State of Ohio Accessible by physicians, pharmacists, and law enforcemen www.ohiopmp.gov

PRESCRIPTION MONITORING PROGRAMS (PMP) STATE OF KENTUCKY Kentucky All Schedule Prescription Electronic Reporting (KASPER) established in 1999 eKASPER established in 2005 Accessible by physicians, pharmacists, and law enforcement https://ekasper.chfs.ky.gov/accessrequest

PRESCRIPTION MONITORING PROGRAMS (PMP) STATE OF INDIANA INDIANA SCHEDULED PRESCRIPTION ELECTRONIC COLLECTION AND TRACKING (INSPECT) Accessible by physicians, pharmacists, and law enforcement officers www.in.gov/inspect

PRESCRIPTION MONITORING PROGRAMS (PMP) STATE OF MICHIGAN MICHIGAN AUTOMATED PRESCRIPTION SYSTEM (MAPS) Accessible by physicians, pharmacists, and law enforcement office Website: https://sso.state.ms.us Email: mapsinfo@michigan.gov Telephone: 517-373-1737

WHY GET INVOLVED? Drug seekers keep physicians from treating legitimate patients Lack of addressing the issue will only increase the problem Perpetuates the patient’s addiction or trafficking by ignoring the problem Increases the cost of healthcare

HOW TO COMBAT THE PROBLEM Educate judges, prosecutors, law enforcement, society as a whole Educate school administrators and parents Educate physicians, nurses, and other individuals in the field of healthcare Educate insurance providers

HOW TO COMBAT THE PROBLEM Encourage coroners to develop databases to track causes of overdose deaths Encourage coroners to develop databases to track the prescribing physicians associated with overdose deaths Encourage prescribing physicians, pharmacists, and law enforcement to utilize prescription monitoring programs

HOW TO COMBAT THE PROBLEM Establish and promote “drug take back” or “drug turn in” programs Educate society to remove unused prescriptions from medicine cabinets Educate society not to store controlled substance prescriptions in medicine cabinets Websites: www.notinmyhouse.com and www.painfullyobvious.com

HOW TO COMBAT THE PROBLEM Propose and pass law requiring photo identification be DISPLAYED and RECORDED when picking up prescriptions for controlled substances Required for pseudoephedrine purchases Required for alcohol purchases Required for tobacco purchases Maybe required when making purchases with check or credit card WHY NOT CONTROLLED SUBSTANCES!!!

Twenty state chapters Comprised pf law enforcement, boards of licensure, doctors, pharmacists, nurses, healthcare insurance providers, etc. Disseminate informatin on a daily basis via email Resources, articles, links, and other information archived in database www.naddi.org

WARREN COUNTY DRUG TASK FORCE QUESTIONS AND COMMENTS THANK YOU!!!