Drug Diversion--The Past 20 Years

A veteran investigator reflects on his 2 decades of experience working with pharmacies to handle drug diversion and abuse cases.

I realized the other day that I had just completed 20 years of being deeply involved in the world of drug diversion. Of course, as a young uniformed law enforcement officer in the early 1970s, I also dealt with prescription drug abuse, but the emphasis was not nearly as focused as it is today. We still have a way to go as we draw near to 2011.

When I was blessed enough to be selected to form and run the Cincinnati Police Department’s Pharmaceutical Diversion Squad (PDS), most of us knew very little about the crimes that constitute drug diversion. In fact, we were not sure what the words “drug diversion” meant, but we were willing to learn about and attack the problem as best as we could. I started with 4 veteran investigators, myself, and a secretary. Later, the investigative ranks would grow to 6 as the volume of cases increased.

I sent my investigators out after splitting up the pharmacies in the city and instructed them to pay these establishments a visit, introduce themselves, give the pharmacists a business card, and ask them to call when they had a prescription drug issue. I also told them that I wanted them to visit each pharmacy at least once a month thereafter. That never happened.

It never happened because the response from our pharmacies was overwhelming, and the calls and cases poured into our office. The best we could do was to try to keep up with the volume of new cases, with virtually no time to revisit pharmacies unless they were one of the apothecaries involved in the case on which the investigator was working.

I wondered out loud, who handled these cases before PDS was formed? The answer was no one, and pharmacists and physicians had quickly become frustrated when complaints were not investigated and reports discouraged by law enforcement. One officer in a regional drug unit had been doing drug diversion work, but the unit had discontinued those kinds of investigations years before we started PDS.

Cell phones were still very new and bulky, if they were even available to law enforcement, and our best tool was the fax machine. However, fax machines would only allow for time-consuming, one-ata- time faxes, and oftentimes were not even located in the pharmacy but in the grocery store manager’s office. Some faxes went through, some did not.

There were no prescription monitoring programs, so many of the attempts to find profiles to prove doctor-shopping cases were done by working off good old shoe leather. The news media was almost enchanted by these new crimes and the attention to prescription drugs. We were able to easily get their cooperation in promoting the new squad, which only increased our workload, including requests from neighboring pharmacies and law enforcement agencies. We were now the resident experts by default, if nothing else.

The drugs have changed some—in those days, hydromorphone, oxycodone, and diazepam seemed to be the biggest drugs of abuse, whereas today’s problems focus mainly around hydrocodone, oxycodone, and alprazolam, to name just the top 3. The thought that these drugs could ever be as addictive and devastating as illicit drugs never entered the public’s mind, nor the minds of the vast majority of law enforcement officers.

Approximately halfway through these 2 decades, extended-release OxyContin came on the scene, and energetic and determined addicts found ways to break into the time-released pharmaceutical to achieve their high. The negative publicity that accompanied the abuse of this drug is probably one of the main reasons that prescription drug abuse awareness was heightened.

The truth is that prescription drug abuse is nothing new, but most of the public and law enforcement were either legitimately not aware of, or else chose to remain ignorant of, a problem that was steadily growing.

Next month, I will explore how the computer age, including the Internet, has both increased drug diversion crimes and made our job easier with prescription monitoring programs and advances in administration in health facilities. PT

Cmdr Burke is commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad. Cmdr Burke is a 40-year veteran of law enforcement and the current president of the National Association of Drug Diversion Investigators. He can be reached by e-mail at burke@choice.net, via the Web site www. rxdiversion.com, or by phone at 513-336-0070.