By Cimaron Neugebauer
The Salt Lake Tribune
Published: January 18, 2011 10:50PM
Updated: January 18, 2011 11:42PM
Paul Fraughton | The Salt Lake Tribune A pharmacist counts out pills at a local pharmacy on Thursday, Jan. 13. Access to the Utah Controlled Substance Database by pharmacists and law enforcement officials has been a key factor in prosecuting more prescription fraud crimes over the past decade.
In 2006, prescription drug fraud was spiraling out of control in Logan.
Pharmacies were reporting forged prescriptions. Patients were shopping for doctors in search of multiple prescriptions. And authorities couldn't effectively prosecute people in their 20s and 30s dealing in painkillers and muscle relaxants such as Soma and Ultram.
The problem sparked a partnership between the Cache/Rich Drug Task Force and prosecutors who began charging unscheduled prescription drug fraud under a different statute. The tactic paid off: A Salt Lake Tribune review of state court records indicated that, since 2006, more unscheduled drug fraud cases have been prosecuted in Logan's 1st District Court than anywhere else.
"When we started it five or six years ago, it was out of control, but now we have it plateaued," said Logan police Detective Rob Italasano. "We have taken an aggressive stance on all medications and not just controlled substances, where other jurisdictions may not even know about it."
Scheduled drugs are those regulated under the Controlled Substances Act. Unscheduled drugs are not regulated under the act. Prescription drugs can be both scheduled and unscheduled.
Statewide, prosecutions of prescription fraud have been steadily increasing during the past decade and peaked with nearly 550 filings in 2008. Prosecutors say the numbers indicate a better collaboration between law enforcement officials and health care professionals fighting fraud - and that Logan's success during the past few years may serve as a model for other communities.
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Database a weapon - Salt Lake County Deputy District Attorney Paul Boyden said law enforcement and pharmacist access to the Utah Controlled Substance Database has been a key factor in prosecuting more prescription fraud crimes during the past decade.
The database collects information on controlled substances sold by all retail, mail-order, institutional and outpatient hospital pharmacies in the state on a weekly basis. Medical professionals and police who demonstrate a valid reason can access it, although the system doesn't issue alerts or flag something that may be suspicious.
In 2010, usage of the database exploded, with an average of 15,000 more searches each month than the previous year. The number of medical practitioners searching it also multiplied threefold last year, when all active prescribing practitioners were required to register with the database and be trained in how to use it.
"Now you regularly see [police] officers saying, 'I checked the DOPL [Division of Occupational and Professional Licensing] database,' and that wasn't happening that much that long ago," said Boyden, who works with legislators to draft legislation, including the Utah Controlled Substances Act.
"We think the database empowers them [police or medical professionals]," said Mark Steinagel, director of DOPL. "Otherwise, they are on an island, not knowing what a patient is telling them. If that patient was going up and down the Wasatch Front, they [police or medical professionals] wouldn't know, but the database brings that all together."
But the database alone isn't enough. The community must notice and take part in fighting the problem, Boyden said.
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The culprits - Prosecutors such as Tyson Hamilton of the Salt Lake County District Attorney's Office, who prosecutes a majority of prescription fraud cases in West Jordan, said most cases around the state are filed against people, rather than doctors or pharmacists.
Drive-through pharmacies seem to be the most common path chosen for fraud, Hamilton said. Cache County Prosecutor Barbara K. Lachmar said fraud isn't limited to a few major offenders at big-box stores.
"You see them in every pharmacy in the valley," Lachmar said.
Those who abuse prescription drugs come from all walks of life, said Cache/Rich Drug Task Force agent Chris Kleven.
"It isn't like these people are out looking for a high. These are your normal, average, working-class, successful citizens," said Kleven, who took Italasano's spot on the task force in December. "All that it takes is an injury or an ailment you were born with to get addicted to these things."
Before the database was available, Kleven said, officers wouldn't have found out someone was abusing prescription drugs until after they interviewed them for a DUI arrest or a family member found them passed out. Now they know within seconds.
"That is the best tool to use for this job. I use it on every single case," he said.
The tool may be most effective when medical professionals become the eyes and ears for law enforcement by using the database.
Richard Rasmuson, a pharmacist at University Pharmacy in Salt Lake City, said his pharmacy is "very vigorous" about reporting fraud or forgeries to law enforcement.
"We just don't mess with those folks. We are right there ... and get the police involved," he said.
The pharmacy has no other choice - Rasmuson said prescription drug fraud has remained consistent throughout the years. What changes, he said, are the types of drugs people are seeking.
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"Too big to handle" - During the past decade, St. George's 5th District Court had one of lowest number of convictions among the state's most populous court districts - only 71.
Former Washington County Sheriff Kirk Smith said his officers were just becoming better at catching the criminals when he left the post in December, despite the obstacles of decreased manpower and funding.
"It is like a giant chess game," Smith said. "We get better [at catching fraud], and those trying to do what they want have to get ahead. We always lag behind a little bit."
Smith said his office has only one or two officers working on prescription fraud on a regular basis and hasn't tried to pursue drugs such as police in Cache County.
"We have enough [scheduled drug] prescription abuse that it is already too big to handle," Smith said.
A statewide task force formed in 2009 aims to assist departments in their efforts to control the problem. The Utah Pharmaceutical Drug Crime Project provides training to police and offers outreach and awareness of the issue to the community.
Out of the $2 million in federal grants recently awarded to the Salt Lake City Police Department, $345,000 went to the project.
Smith said he feels fixing the problem will require more eyes and ears in the community notifying police.
"If the community expects us to solve [this prescription fraud] drug problem, they need to take a closer look at who is purchasing this stuff," Smith said, noting the crime commonly originates within everyday homes in the community. "To think law enforcement is going to solve the problems in the community ... I don't think that is realistic."
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How to help
Authorities say community members can curb prescription drug fraud by being observant and disposing of prescription drugs through take-back programs.
Find a complete list of locations to take unused prescription drugs at www.medicationdisposal.utah.gov. Police ask community members to be vigilant for:
Family members or friends who go to multiple providers for the same ailment, or seek to go to the emergency room often.
Family members or friends who frequently ask to use your bathroom - some may be looking through your medicine cabinet.
Someone who knows you have pain pills and frequently asks you questions about them.
Thieves who may target cancer patients or those who have died of cancer, knowing they have stronger pain medication in their homes and are often cared for by outsiders coming into the home.
Thieves who may watch obituary listings and break into a home to steal medications during a funeral.
Strangers in the neighborhood or unusual activity.
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Anatomy of a fraud
In one case, an observant pharmacist led to the discovery of more than 400 prescriptions authorized under a doctor's name and filled for people around Salt Lake County.
The scheme unraveled in August 2005, when a Smith's pharmacist called Midvale police after growing suspicious of a woman who had sought 60 pills of hydrocodone 26 times in a one-year period. The prescriptions were all supposedly prescribed by the same doctor.
The doctor told police she didn't recognize the patient's name and that she didn't prescribe the drug in those amounts. Detectives used a statewide controlled-substances database to discover 427 prescriptions of the Lortab generic were filled for about 50 people, each for 60 pills.
Questions about the fraud led to the doctor's office.
Pharmacy records indicated that each time a prescription was called in, it was done by someone in the office other than the doctor. The same person who called it in would also authorize it when the patient came to pick it up from the pharmacy. The culprit: the doctor's secretary.
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Prescription drug abuse in Utah
Utah Division of Substance Abuse and Mental Health figures indicate prescription drug abuse admissions increased by 68 percent between 2006 and 2009 but remained flat in 2010.
A 2008 federal National Survey on Drug Use and Health, the most recent available, indicated that 4.9 percent of respondents 12 years of age or older in the Utah population had misused painkillers in the past year.
That put the state on par with the national average of 4.8 percent.
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© 2011 The Salt Lake Tribune
