Pubdate: Wed, 3 Jun 2009
Source: Daily Reflector (Greenville, NC)
Copyright: 2009 Daily Reflector
Author: Ginger Livingston


The Pitt County Sheriff's Office investigated 46 cases of illicit
prescription drug use in 2008. That only scratched the surface of a
growing issue, Sheriff Mac Manning said.

"That's one detective who is working what amounts to a case a week,"
Manning said. "And we know there is a much bigger problem." The
problem is becoming so commonplace, Manning, with assistance from
state Rep. Marian McLawhorn, D-Pitt, is pursuing legislation that
would allow North Carolina's 100 sheriffs to access the Controlled
Substances Reporting System database that is operated by the state's
Department of Health and Human Services.

The reporting system requires pharmacists to document with the state
every Schedule II through Schedule V prescription filled. The levels
are used to identify narcotics, painkillers, stimulants and medicines
for anxiety and depression.

Manning said the original goal of the database was to give doctors a
resource for identifying people who were visiting more than one doctor
to obtain multiple prescriptions of such medications. However, only
3,900 of the state's 29,000 medical practitioners are connected to the
system. The State Bureau of Investigation has access to the system for
investigative purposes. Manning said allowing sheriff's investigators
similar access expands the number of law enforcement officers
investigating suspicious prescriptions.

"There are some estimates that the prescription diversion problem has
become as great as the illegal drug trade," Manning said.

The nonmedical use of prescription pain relievers is the second most
common form of illicit drug use in the United States, according to the
2007 National Survey on Drug Use and Health conducted by the federal
government's Substance Abuse and Mental Health Services
Administration. It's a boon to drug dealers because the illegal use
and sale of these drugs does not carry the serious criminal penalties
associated with cocaine, heroin and marijuana, Manning said.

The drugs are easy to obtain, he said. It's not unusual for someone
who receives painkillers for dental work or other injury to have
leftover painkillers. People with legitimate injuries and illnesses
will doctor shop, visit multiple physicians to get multiple
prescriptions for painkillers. There's also a growing trend in copying
a prescription and having it filled at multiple pharmacies, Manning

It's not only illegal to use painkillers for a nonmedical use, there's
also the negative financial impact on health insurance providers,
prescription drug plans and taxpayer subsidized programs like
Medicaid, Manning said. In one case investigated by Manning's office,
a Medicaid recipient had 25 fraudulent prescriptions filled. It cost
taxpayers approximately $11,600 to fill those prescriptions, Manning

In 2008, Manning's office investigated 46 drug diversion cases,
resulting in 30 arrests.

The proposed legislation would allow deputies to check the reporting
system only during an ongoing investigation of suspicious activity and
reports of abuse. They would not be allowed to monitor the system to
identify suspicious trends, Manning said.

Manning said if a pharmacists suspect a prescription is counterfeit,
for instance, investigators can check the system to see if multiple
attempts have been made to fill the prescription.

Currently, a detective has to secure a subpoena and call individual
pharmacies to check for duplications.

If a supplier's name comes up in an investigation, a records check
would allow detectives to see if the person is doctor shopping. "It
saves the detectives a lot of legwork and knocking on doors," Manning
said. "It can narrow their search." The proposed legislation would
only open the files to sheriff offices, not police departments.
Manning said when discussing the bill's language, it was thought best
to limit it to sheriff offices in the beginning. The legislation is
before the state House of Representatives' Judiciary III committee.
Chairman Ronnie Sutton, D-Robeson, promised a thorough hearing of the
bill after work on the state budget is completed, McLawhorn said late
last week. Concerns about privacy violations also are being discussed,
McLawhorn said, and changes have been added that should eliminate
abuse. Before launching a search, the legislation would require
formation of an official case file. Investigators would report the
search to the attorney general's office and any findings of unusual
patterns of prescribing drugs. Deputies would have to undergo 10 hours
of training about the system before using it, she said, and additional
software would have to be purchased. The purchase of the software and
the need for personnel to work with law enforcement may be the biggest
obstacle to the legislation's passage. McLawhorn said the
appropriation would be just over $100,000 but it would be considered
program expansion money and a moratorium has been placed on expanding
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