1. DEA’s Most Wanted: Commonly Diverted Controlled Substances
Schedule II
Morphine
(MS Contin)
* Street value $2 per mg
($30-$200 for most pills)

2. DEA’s Most Wanted: Commonly Diverted Controlled Substances
Schedule II
Hydromorphone
(Dilaudid)
* Street value $10 per mg
(avg. $20-$60 per pill)

3. DEA’s Most Wanted: Commonly Diverted Controlled Substances
Adderall
Schedule II
Meperidine
(Demerol)
Methadone

4. DEA’s Most Wanted: Commonly Diverted Controlled Substances
Schedule II
Hydrocodone
w/Acetaminophen
(Lorcet; Lortab; Vicodin)
* Street value $5-$10 per pill

5. Hydrocodone Vicodin®, Lortab®, Lorcet® #1 Most Prescribed Drug in US*
Most commonly abused and diverted pharmaceutical
Structurally related to codeine and approximately equal to morphine in producing opiate-like effects
Rap star Eminem has a Vicodin® tattoo on his arm and a picture of a Vicodin® tablet on one of his CDs
© Shady Records
*AARP Bulletin; Vol 50, No 6; October 2009
*SOURCE: 2005 Monitoring the Future study released Dec MTF is conducted by the Institute for Social Research at the University of Michigan.

6. DEA’s Most Wanted: Commonly Diverted Controlled Substances
Schedule III
Codeine w/Acetaminophen
(Tylenol #3)
* Street value $2-$4 per pill

7. DEA’s Most Wanted: Commonly Diverted Controlled Substances
Schedule IV
Alprazolam
(Xanax)
* Street value $3-$5 per pill

8. The “Holy Trinity” Soma (carisoprodol) – Muscle relaxant
Xanax (alprazolam) – anti-anxiety
Vicodin (hydrocodone) – narcotic
These three drugs, when taken in combination, are known as the “holy trinity” by abusers. This combination gives abusers a feeling of euphoria, similar to that of heroin.

9. Source of Rx Narcotics Used Non-Medically 2010
Bought on Internet 0.4%
Drug Dealer/ Stranger 4.3%
Other 4.9%
More than One Doctor
1.6%
One Doctor
18%
Free from Friend/Relative 55.9%
Bought/Took from Friend/Relative 14.3%
Note: Totals may not sum to 100% because of rounding or because suppressed estimates are not shown.

10. Regulations: Closed System of Distribution
Cyclic
Investigations
Established
Schedules
Record Keeping
Requirements
Registration
Security
Requirements
Established
Quotas
ARCOS

11. Rx Diversion Methods Illegal prescribing Fraudulent Rx
Forged or Altered
Illegal sales
Internet
Employee theft
Prescription rings
Doctor shopping
Pharmacy theft
Hatfield Brothers – 85 Pharmacy Burglaries in 10 states.
Foreign diversion and smuggling into the U.S.

12. Pharmacy Robberies & Break-Ins
* thru June 27, 2011

13. Sanofi Aventis Armed Robbery
Suspect attached rope to one drum and dragged it down the stairs, down a ramp, and to the pedestrian doorway at the loading dock level
Suspect abandoned the other three drums

14. How Criminal Internet Pharmacies Really Work
Pharmacy in Dubuque, Iowa
Shipping 250 boxes daily for Medical Web Services, 600 daily for Pharmacom
Two internet companies involved
Approximately 50 practitioners
Seizures in excess of $8 million
Sentencing ranged from probation to five years incarceration.

15. Internet Targets 1 1 2 1 14 2 3 1 Pharmacy 25 1 1 2 1 1 2 2 3 1 1 1 2 3 2 1 2 1 1 13 14 9 2 3 1
Pharmacy 2
Internet Website Companies
Pharmacists 50
Doctors 15
Corporate Directors, Employees

16. Internet Doctors Diaz, Mario, M.D.
Pled guilty to conspiracy to distribute schedule III and IV controlled substances. Authorized at least 53,125 dosage units of schedule III controlled substances and 17,890 dosage units of schedule IV controlled substances.
Sentenced to 30 months incarceration, two years supervised release, forfeiture of $272,061.

17. Internet Doctors McNeil, Apryl, M.D.
Pled guilty to conspiracy to distribute schedule III and IV controlled substances. Authorized at least 220,090 dosage units of schedule III controlled substances and 15,510 dosage units of schedule IV controlled substances.
Sentenced to 20 months incarceration, two years supervised release, forfeiture of $26,960.

18. Internet Doctors Millette, Michael J., M.D.
Pled guilty to conspiracy to distribute schedule III and IV controlled substances. Authorized at least 61,202,400 dosage units of schedule III controlled substances and 1,446,810 dosage units of schedule IV controlled substances.
Sentenced to 41 months incarceration, two years supervised release. Ordered to forfeit $1.6 million.

19. Schneider Medical Clinic
A Case Study:

20. Schneider Medical Clinic
March 2005, the Kansas City District Office received a complaint regarding the excessive prescribing of narcotics and other controlled substances by Stephen J. Schneider, D.O., and the staff at Schneider Medical Clinic, Haysville, Kansas.
Prescribed Duragesic (fentanyl) Patches, Actiq suckers (a lollipop of fentanyl), hydrocodone, Xanax, Valium, Soma and Oxycontin
Kansas Bureau of Investigation reported eight deaths of Schneider patients in the past two years.

21. Schneider Medical Clinic
Red Flags:
Clinic open seven days a week
As many as 11 hours a day
Patients scheduled 10 minutes apart
Patients waited for hours for an appointment
Numerous reports of overdose

22. Schneider Medical Clinic
Over 300 patient files and other documents seized.

23. Cases Against Doctors Dr. Stephen Schneider
Conspiracy to commit healthcare fraud
Unlawful distribution of controlled substances
Health care fraud resulting in death
Submitting false claims to Medicaid and private insurers
Money laundering
Sentenced to 30 years imprisonment

24. Cases Against Doctors Linda Schneider
Conspiracy to commit healthcare fraud
Aiding and abetting the unlawful distribution of controlled substances resulting in death
Health care fraud resulting in a death
Aiding and abetting submitting false claims to Medicaid and private insurers
Money laundering
Sentenced to 33 years imprisonment

25. Questions Judy R. Williams Group Supervisor
Kansas City District Office
(913)