2. Opioids, Synthetics and Cannabis……. OH MY!
Detective Sgt. Terrell
Sublette County Sheriff’s Office

3. FAR FROM THE YELLOW BRICK ROAD

4. Background Graduated from the University of Wyoming
Taught Agricultural Education/FFA at Pinedale High School for 10 years
Began at Sublette County Sheriff’s Office in 2001
Detentions
Patrol/Detectives
Narcotics K
Field Training Officer
Narcotics Task Force
WY DCI Task Force Officer
Detective Sergeant 2016

5. So what are our biggest problems?

6. Alcohol and weed, correct?
Marijuana
THC Edibles, THC Wax, THC Oil, Plant Material, Live Plants
Methamphetamine
Cocaine
LSD - Lysergic Acid Diethylamide
LSA - Lysergic Acid Amide
Prescription Medications
Fentanyl, Xanax, Adderall, Dilaudid, Oxycodone, Oxycontin, Hydrocodone
Psilocybin Mushrooms
MDMA
Heroin
PCP
Powdered Fentanyl Combinations

13. The following statistics are from ONE pharmacy in Sublette County, spanning over a three month period in 2016.
-45,349 (capsules, tablets, ect) of Narcotics were dispensed.
Four (4) of the top Five (5) are pain medications.
-1,769 Tablets of 5 mg Percocet.
-2,670 Tablets of 10 mg Ambien.
- 3,580 Tablets of 5 mg Hydrocodone.
- 4,435 Tablets of 10 mg Hydrocodone (average of 113 per Rx filled).
- 4,847 Tablets of Tramadol.

14. When multiplying the above statistics out to a yearly average, the numbers are as follows:
-181,396 total Narcotics dispensed.
-7,076 Tablets of 5 mg Percocet
-10,680 Tablets of 10 mg Ambien.
-14,320 Tablets of 5 mg Hydrocodone.
-17,740 Tablets of 10 mg Hydrocodone
-19,388 Tablets of Tramadol
On average, Sublette County investigations into the illegal distribution of Prescription Narcotics has shown that each tablet which is illegally sold, sells for one dollar ($1.00) per milligram. Using the above example of the 10 mg Hydrocodone statistic, at an average of 113 tablets per transaction, that one prescription is worth $ on the street.

15. PROBLEM
“Doctor Shopping” is becoming a common scheme amongst Prescription Narcotic abusers. Our current system does not facilitate an avenue for Doctors and Pharmacists to instantly check a patient’s history of Narcotic prescriptions prior to issuing additional prescriptions. In other words, the left hand has no idea what the right hand is doing, which addicts and drug dealers have exploited.

16. PROPOSED SOLUTION
Implementing a web based computer system that mandates medical professionals holding a DEA license to access patient Prescription Narcotic records prior to writing a new prescription for any and all controlled substances as defined in Wyoming State Statutes through In addition, the medical professional shall also immediately report to the web based system if he/she decides to issue a prescription for any narcotic, so that this information may be accessible at a later time for other medical professionals.

17. Doctors:
-Prior to the Provider issuing any new Narcotic Prescription, the Provider will check the web based system for any recently issued Narcotic Prescriptions.
-If the Provider decides to issue a new prescription, the Provider will enter in the desired Narcotic, number of pills prescribed, strength of prescription prescribed and daily dose, so a future Provider can make an educated decision if the patient is truly in need.
Pharmacist:
-Prior to dispensing the prescription, the Pharmacist shall access the web based program to determine the validity of the issued Narcotic Prescription.
-The Pharmacist shall also check for recently issued prescriptions and make an educated decision as to fill the prescription or not.
-The Pharmacist/Pharmacy shall report to the web based system immediately upon filling the prescription.

18. Law Enforcement:
-Have limited access to use as a tool where reasonable suspicion exists that a patient/suspect is illegally distributing his/her narcotic prescriptions.
-When a person is charged with a crime involving the distribution of prescribed narcotic drugs, the court in which the subject is charged shall report to the web based program. This is to educate Medical Providers that the patient may or may not truly need the amount of Medication currently being prescribed.

21. Thank You! Detective Sgt. Toby Terrell
Sublette County Sheriff’s Office
PO BOX 701
Pinedale, WY
ext. 5208