5woo catjan2006 print

Rx Drug Terms
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Drugs are categorized by State and
Federal Government according to abuse
potential. Drugs in general fall into three
major categories.
1. Over the counter (OTC)
2. Dangerous Drugs
3. Controlled Substances I-II-III-IV-V
San Diego Regional
Pharmaceutical Narcotic
Enforcement Team
RxNET
• CA Dept of Justice Bureau of Narcotic
Enforcement
• Drug Enforcement Administration
Topics
• Impact On Your Community
Drug Categories
• OTC – Drugs obtained in a drug store which can
be self-administered safely with directions on the
packaging.
• Dangerous Drugs – Drugs which require a
prescription. Any drug that bears the legend:
"Caution: federal law prohibits dispensing
without prescription," "Rx only," or words of
similar…, SOMA, antibiotics, birth control pills
and anti-hypertensive medication.
Scheduling of Controlled Substances
• Whether a drug has legitimate medical use.
• Current Trends In San Diego County
• Task Force Approach
The potential for abuse;
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psychological addiction
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physical dependence
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Examples:
Hydrocodone (Generic) 10mg
• Schedule I: Heroin, LSD, PCP, Marijuana
• Schedule II: Cocaine, Demerol, Fentanyl,
Dilaudid, Ritalin, Oxycontin, Methadone,
Morphine
• Schedule III: Vicodin, Norco, Lortab/Lorcet,
Steroids
• Schedule IV: Phentermine, Valium, Xanax,
Darvocet
• Schedule V: Lomotil
Commonly Abused Rx Drugs
OPIATES
• OxyContin – CII
• Vicodin – CIII
• Norco – CIII
• Lortab – CIII
BENZODIAZEPINES
• Valium - CIV
• Xanax - CIV
STIMULANTS
• Ritalin, Adderall– CII
Vicodin
5mg
Norco
Lortab
7.5mg
10 mg
2
Soma
Valium
Non-Scheduled
XANAX
Actiq
“Zany
Bars”
OxyContin
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Resources for Identification of
Rx Drugs
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Poison Control – (800) 876-4766
Drug ID Bible – www.drugidbible.com
RxNET – (858) 495-3610
DEA Diversion – (858) 616-4100
DEA DRUG ABUSE
WARNING NETWORK
(DAWN)
• Based on Emergency Room admissions &
medical examiners (nationwide)
• Combined pharmaceutical admissions are
second only to cocaine
• Marijuana and heroin are 3rd and 4th
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How Big is the Problem?
• 5% of the population is actively addicted
• 20% of active addicts primarily abuse
pharmaceuticals
• Addiction recognizes no socio-economic
boundaries
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CA Board of Pharmacy Stats
Types of Rx Fraud
• Rx drugs are the fastest growing group in
the illicit drug market
• 30% of all drug related deaths involve Rx
drugs
• 25% of all drug related ER admissions
involve Rx drugs
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Written Prescriptions
Altered Quantity
• Altered
• Stolen
• Copied
• Forged
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2 Added to Refills
Alprazolam Added
Computer Made Rx
Altered to 4 Refills
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Telephonic Prescriptions
Effects of Hydrocodone
• Most common
• Most difficult to identify suspect
– Impersonates medical staff
– Calls during off hours
– Frequently patients or employees of victim
doctor
– Often overly friendly
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Doctor Shoppers
Consumption/Abuse
• How the law applies to them
• Use of multiple
doctors/pharmacies
• Providing false information
to the doctors
• Don’t tell Dr.’s about other
Dr.’s they have seen
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Oral consumption
Dissolve in water
“Booty Buster”
Drug abusers grind up the drug, snort or
inject it to get an instant high
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Fraud by MO
12.6%
Why so appealing
3.8%
Phone In
Written
16.4%
48.3%
Dr. Shopper
Altered
19.0%
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Clean
“Not as bad as illicit drugs”
Easy to Obtain
Television - Celebrities
Accidental Addicts
Other
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No Socio Economic
Boundaries
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Working Professional
Physicians
Nurses
Law Enforcement
Pharmacist
Commercial Pilots
How You Can Help Prevent This
Activity
• Written-Write out numbers and quantities
and line out unused portions of Rx form.
• Phone in-Be available for confirmation calls
from pharmacies.
• Shoppers-Assess patients and treat/prescribe
accordingly.
• Report any criminal/fraudulent activity.
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The Typical Investigation
• Contacted by pharmacies,
doctors, family, staff, etc.
• A fax alert is sent out to
determine the extent of the
fraud
• Conduct interviews with the
involved parties
• Make arrest if appropriate
• Refer for prosecution
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Jack Osborne & MTV
Patient Confidentiality
•Medical records vs.
narcotic/Rx records
•Failure to maintain and
produce records (4332 B&P)
•Pharmacy records (4333 B&P)
•11195 HS Receipt required for
original Rx
•HIPAA 164.512(f)(5)
Permitted disclosure to L/E
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Administrative Referrals
Common Charges
• 11173(a) H&S – Attempt/Obtain Controlled
Substance by Fraud.
• 459(b) PC – Commercial Burglary
• 550(a)(6) PC – Insurance Fraud
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Doctors – State Medical Board, DEA
Nurses – State Nursing Board
Veterinarians – State Veterinary Board
Physician Assistants – State Medical Board
Dentists – State Dental Board
Pharmacists – State Pharmacy Board
FAA-Licensed Pilots
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Typical Outcomes
• Probation for first time offenders
• Normally custody is limited to the
time of arrest
• Drug Court (Usually case is dismissed upon
completion of Drug Court Program)
• Chronic, repeat offenders
receive local or state
custody
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Task Force Services
• Assist or Handle Pharmaceutical Diversion
Investigations in Your Jurisdiction or
Facility and Intervene Appropriately
• Provide Training/Education
– To Law Enforcement Personnel
– To Medical Staffs
– To Pharmacy Staffs
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RxNET
Yesterday Today Tomorrow
• Yesterday-Uncoordinated or minimal response by
individual agencies to a growing pharmaceutical
abuse problem.
• Today-RxNET Task Force-BNE/DEA formed
Task Force to coordinate and develop multi-level
enforcement response.
• Tomorrow-Efficient multi-level proactive
Pharmaceutical Task Force sufficient in size and
participation to impact the problem.
RxNET Contact Information
Task Force Hot Line
858-495-3610
John Woo 858-495-3638
[email protected]
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