Pubdate: Sun, 29 Nov 2015
Source: San Diego Union Tribune (CA)
Copyright: 2015 Union-Tribune Publishing Co.
Contact:  http://www.utsandiego.com/
Details: http://www.mapinc.org/media/386
Note: Seldom prints LTEs from outside it's circulation area.
Author: Kristina Davis

Pharmacies

DRUG ENFORCEMENT OF PHARMACIES STEPPED UP

Federal Agents Say Proper Record-Keeping Helpful in Fight

On July 13, 2012, a pharmacy technician ordered 1,000 hydrocodone 
pills through the San Diego pharmacy he worked for.

But it was not a sanctioned order. The highly addictive drugs were 
either meant for his own consumption, or to restock the pharmacy's 
supply of pills he had already stolen, concluded the state Board of 
Pharmacy, which ultimately revoked his license after he was convicted 
of prescription forgery and burglary.

The incident helped spark a massive investigation into Medical Center 
Pharmacy, a collection of a dozen family-owned pharmacies that 
operate throughout San Diego County. What the U.S. Drug Enforcement 
Administration found was a system that lacked controls on the 
distribution of controlled substances, shoddy record-keeping and lax 
procedures on dispensing pseudoephedrines, which can be used to make 
methamphetamine, the U.S. Attorney's Office announced this month.

The investigation also found a total of 21,000 oxycodone and 
hydrocodone pills that were unaccounted for from four San Diego 
pharmacies over a two-year span. In some instances, the drugs are 
believed to have been delivered to a home used by pill seekers, 
authorities said.

The effort to combat the illegal flow of pharmaceuticals from 
legitimate businesses is intensifying as prescription drug abuse 
remains a top public health concern.

The DEA, which enforces pharmacy compliance with federal drug laws, 
has increased the amount of surprise inspections on businesses in 
recent years. And the state board that licenses pharmacists and 
similar workers is considering making it mandatory for pharmacies to 
inventory their drug supplies once every quarter to better stem the 
illicit flow.

Pharmacies are currently required to report when drugs go missing. 
Last year in California, 1 million dosages of pills were reported 
lost, said Virginia Herold, executive officer of the state board. The 
year before it was about 1.5 million.

"The problem is controlled substances are so valuable on the street 
compared to their value in the pharmacy," Herold said. Some pills go 
for $30 each or more, she added.

Employees who divert pills are either addicted to the drugs 
themselves, or just selling them for the money, said DEA Supervisory 
Special Agent Thomas Lenox.

Besides pill diversion, other major problems that authorities look 
for is poor record-keeping and pharmacists who are more focused on 
filling a prescription than doing their due diligence to make sure 
the prescription is legitimate and not stolen, forged or counterfeit.

"The one thing is, it's all paper," Lenox said of the stringent 
record-keeping required of pharmacies. "You either have the 
documentation or not. If you don't have them, you're in violation."

Investigators say the problems are seen just as much at large, chain 
pharmacies as at smaller mom-and-pop pharmacies. The only difference 
is volume: Missing pills are also sometimes spotted faster at the 
larger chains due to more-stringent corporate policies in place, Herold said.

Earlier this year, CVS Pharmacies and the U.S. Attorney's Office 
entered into a $22 million settlement after an investigation showed 
some pharmacies in Florida were knowingly filling illegitimate 
prescriptions for painkillers.

Authorities can go after offending pharmacies in various ways, from 
sending a letter of admonition to taking away the DEA registration 
that allows them to sell controlled substances to civil enforcement 
to criminal charges. The state board can also go after licenses of 
individual workers. Licensed workers do undergo background checks, Herold said.

In the Medical Center Pharmacy investigation, authorities went the 
civil enforcement route, resulting in a $750,000 settlement last week.

The corporation, owned by Joseph and John Grasela, operates several 
storefronts under names such as Galloway Medical Center Pharmacy, 
Community Medical Center Pharmacy and Medical Center Pharmacy.

Besides the missing pills, authorities said the pharmacies also 
violated the Combat Methamphetamine Epidemic Act, which requires 
pharmacies to keep a logbook of sales of certain over-the-counter 
medications that can be used to make meth.

The records must include the buyer and the product purchased, and are 
intended to prevent individuals from buying large quantities of the same drug.

The pharmacies have had problems with the board before, Herold said. 
As part of the settlement, the owners have agreed to implement new 
inventory-control measures, authorities said.

This case is just the most recent example of similar pharmacy 
misconduct in the county.

Last year, a Hillcrest pharmacist lost her Sixth Avenue Pharmacy over 
allegations of failing to account for 16,000 missing oxycodone pills, 
dispensing drugs with invalid or nonexistent prescriptions, 
exchanging drugs for services or advancing pills to customers, 
according to the U.S. Attorney's Office.

In 2008, federal agents raided three San Diego pharmacies on 
allegations that several employees were diverting painkillers.

The DEA works closely with the pharmacy board to educate pharmacies 
on drug trends, how to spot theft, and security measures such as 
surveillance cameras, keeping addictive drugs under lock and key and 
keeping stocks of such painkillers low.
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