Fighting Prescription Fighting Prescription Drug Abuse in Lake Drug Abuse in Lake

CountyCounty::

A Partnership In The A Partnership In The Community Between The Community Between The

Citizens, Physicians, Citizens, Physicians, Pharmacies and Law Pharmacies and Law

Enforcement Enforcement

Presented by:Presented by:

Sgt. Chris BegleySgt. Chris Begley

Lake County Narcotics AgencyLake County Narcotics Agency

Pharmaceutical Drug Diversion UnitPharmaceutical Drug Diversion Unit

January 25, 2013January 25, 2013

Lake County Narcotics AgencyLake County Narcotics Agency

•Formed in Formed in 19791979, ,

•Financed with County funds, Financed with County funds,

•To assist the county’s police To assist the county’s police departments to collectively fight the departments to collectively fight the new war on drugs.new war on drugs.

•Three distinct units; “street drugs”, Three distinct units; “street drugs”, DARE & PDDU.DARE & PDDU.

•LCNA Agents are appointed, have full LCNA Agents are appointed, have full arrest powers and county-wide arrest powers and county-wide investigative jurisdiction.investigative jurisdiction.

History of the LCNAHistory of the LCNA 19821982: : PermanentPermanent tax levy was passed tax levy was passed

to fund the Agency & an Executive to fund the Agency & an Executive Board was formedBoard was formed

19911991: Executive Board was : Executive Board was restructured restructured to to include the Lake County Prosecutorinclude the Lake County Prosecutor

19941994: Tax levy funding was increased : Tax levy funding was increased for the first timefor the first time

SEVEN MEMBER EXECUTIVE SEVEN MEMBER EXECUTIVE BOARDBOARD

Director David FrisoneDirector David Frisone

Chairman Mayor David Anderson, Chairman Mayor David Anderson, WilloughbyWilloughby

Commissioner Robert AufuldishCommissioner Robert Aufuldish

County Prosecutor Charles County Prosecutor Charles CoulsonCoulson

Chief Troy Hagar, Painesville PDChief Troy Hagar, Painesville PD

Chief Mark Kish, Fairport Harbor Chief Mark Kish, Fairport Harbor PDPD

Chief Wayne Baumgart, Kirtland Chief Wayne Baumgart, Kirtland PDPD

Chief Randy Ice, Wickliffe PDChief Randy Ice, Wickliffe PD

Misconceptions About Rx Drugs:Misconceptions About Rx Drugs:

““Pharming” from the family medicine cabinet, or that of an Pharming” from the family medicine cabinet, or that of an extended family member, is entirely safe. extended family member, is entirely safe.

Rx drugs are completely safe or safer than illegal street drugs.Rx drugs are completely safe or safer than illegal street drugs.

There is no shame or social stigma attached to using / abusing Rx There is no shame or social stigma attached to using / abusing Rx drugs.drugs.

There are virtually no side affects with Rx drugs.There are virtually no side affects with Rx drugs. There is nothing wrong with using prescription drugs without a There is nothing wrong with using prescription drugs without a

doctor’s prescription once in a while.doctor’s prescription once in a while.

Prescription pain relievers, sleep aids, anti-depressant drugs, Prescription pain relievers, sleep aids, anti-depressant drugs, prescribed by a doctor, provided by a pharmacist and paid for by prescribed by a doctor, provided by a pharmacist and paid for by an insurance company are not addictive.an insurance company are not addictive.

Partnership for a Drug-Free America Partnership for a Drug-Free America www.drugfree.orgwww.drugfree.org

Rx MedicationsRx Medications::The New “Gateway” DrugThe New “Gateway” Drug

With Rx drugs being so easy to With Rx drugs being so easy to obtain these days, by all age groups obtain these days, by all age groups of potential abusers, and having so of potential abusers, and having so little negative social stigma attached little negative social stigma attached to them, Rx drugs have now become to them, Rx drugs have now become the preferred drug of choice for the the preferred drug of choice for the “first-timer” abuser of narcotic drugs. “first-timer” abuser of narcotic drugs.

88

Results from the 2011 Results from the 2011 National Survey on National Survey on

Drug Use and Health Drug Use and Health (NSDUH)(NSDUH)

Drugs Drugs UsedUsed Among Persons Aged 12 or Older: Among Persons Aged 12 or Older: 20102010

Fig5.1

Numbers in Thousands

2,1502,063

1,112977

860 845 783

267 26491 69

0

500

1,000

1,500

2,000

2,500

Marijuana Heroin

Pain Relievers

Cocaine

LSDTranquilizers PCPInhalantsEcstasy

Stimulants Sedatives

National StatisticNational Statistic

26% of High School students 26% of High School students participating in a recent national participating in a recent national survey stated that they have either survey stated that they have either used, tried or experimented withused, tried or experimented with someone else’s Rx medications for someone else’s Rx medications for recreational use*.recreational use*.

*(Without a prescription or beyond a *(Without a prescription or beyond a legitimate medical use for the drug.) legitimate medical use for the drug.)

Average Abuse Deaths per Age Average Abuse Deaths per Age Group for every 100K persons:Group for every 100K persons:

15 – 24 yrs. : 15 – 24 yrs. : 340340 25 – 34 yrs. :25 – 34 yrs. : 700700

35 – 44 yrs. :35 – 44 yrs. : 1,0001,000 45 – 54 yrs. :45 – 54 yrs. : 1,2001,200

55 – 64 yrs. :55 – 64 yrs. : 340340

So…So…

What is happening in Lake County What is happening in Lake County associated with the use, misuse and / associated with the use, misuse and / or abuse of pharmaceutical drugs…?or abuse of pharmaceutical drugs…?

A A CommonCommon Addiction… Addiction…

It is a very common fact that , “an opiate It is a very common fact that , “an opiate addiction is an opiate addiction is an addiction is an opiate addiction is an opiate addiction”.opiate addiction”.

It is a very common occurrence for a It is a very common occurrence for a person to quickly become addicted to person to quickly become addicted to many different types of opiate-based many different types of opiate-based narcotic drugs, narcotic drugs, or even Heroinor even Heroin, using both , using both interchangeably when the need arises.interchangeably when the need arises.

What Is The Price of Illegal What Is The Price of Illegal Prescription Drug DiversionPrescription Drug Diversion??

Private Medical and ER costs rise.Private Medical and ER costs rise.

Work loss impacts employers & co-Work loss impacts employers & co-workers.workers.

Health Insurance rates increase:Health Insurance rates increase:

first to finance the addiction, then to first to finance the addiction, then to finance the rehabilitation treatment.finance the rehabilitation treatment.

The PriceThe Price…, con’t:…, con’t:

Innocent people are injured in MVAs Innocent people are injured in MVAs due to DUI/Drugs incidents. due to DUI/Drugs incidents.

Other crimes are committed, i.e. Other crimes are committed, i.e. insurance fraud, thefts, robberies, insurance fraud, thefts, robberies, burglaries, various state drug laws burglaries, various state drug laws are violated to finance addictions. are violated to finance addictions.

Taxes rise to finance the prosecution Taxes rise to finance the prosecution and probation of arrested persons…and probation of arrested persons…

The PriceThe Price, con’t…, con’t…

Personal losses; family problems, Personal losses; family problems, employment termination, health employment termination, health problems, (i.e. death), etc.problems, (i.e. death), etc.

Brings criminals into communities or Brings criminals into communities or neighborhoods where they would not neighborhoods where they would not normally enter or frequent (pill mills)normally enter or frequent (pill mills)

S.A.M.H.S.A.S.A.M.H.S.A.

““The The SSubstance ubstance AAbuse and buse and MMental ental HHealth ealth SServices ervices AAdministration announced the dministration announced the award of 44 new grants for award of 44 new grants for $38.2 million$38.2 million over the next three years to expand the over the next three years to expand the treatment capability of adult drug courts treatment capability of adult drug courts to deal with the treatment needs of people to deal with the treatment needs of people who find themselves in the criminal justice who find themselves in the criminal justice system largely because of underlying system largely because of underlying substance abuse problems.” (Media-substance abuse problems.” (Media-Newswire.com, 10/07/09) Newswire.com, 10/07/09)

More Tax Money…More Tax Money…

On 04/11/11, Ohio Gov. Kasich announced On 04/11/11, Ohio Gov. Kasich announced that $36 million* in new funds would be that $36 million* in new funds would be allocated to help Ohioans, allocated to help Ohioans, who are who are addicted to Rx drugsaddicted to Rx drugs, get the treatment , get the treatment they need to get back into the workforce.they need to get back into the workforce.

*Source of the funds derived from Ohio *Source of the funds derived from Ohio Depts. Of Health, Alcohol & Drug Addiction Depts. Of Health, Alcohol & Drug Addiction Services, Rehabilitative Services Comm. & Services, Rehabilitative Services Comm. & the Federal Gov’t.the Federal Gov’t.

DDrug rug AAbuse buse WWarning arning NNetwork etwork (DAWN)(DAWN)

According to nationally collected data, (as According to nationally collected data, (as of the year 2010), of the year 2010), ~100 persons die~100 persons die each dayeach day from “unintentional from “unintentional pharmaceutical drug poisonings” pharmaceutical drug poisonings” (overdoses) in the United States. (overdoses) in the United States.

As of the year 2009 Ohio led the nation in As of the year 2009 Ohio led the nation in such deaths… such deaths…

FACTFACT::

With this increased rate of deaths in Ohio, With this increased rate of deaths in Ohio, attributed to the abuse and misuse of attributed to the abuse and misuse of pharmaceutical drugs, accidental drug pharmaceutical drugs, accidental drug overdoses now kill more Ohioans annually overdoses now kill more Ohioans annually than traffic accidents. than traffic accidents.

Between 2003 and 2010, >9,000 persons Between 2003 and 2010, >9,000 persons died from Rx drug poisonings in Ohio.died from Rx drug poisonings in Ohio.

(Per Ohio Dept. Health data) (Per Ohio Dept. Health data)

LeadingLeading cause of ACCIDENTAL cause of ACCIDENTAL death in Ohio:death in Ohio:

According the According the State of Ohio Department of State of Ohio Department of HealthHealth, as of the year 2011, , as of the year 2011, 55.8 persons .8 persons diedie each dayeach day in the State of Ohio in the State of Ohio from from “unintentional pharmaceutical drug “unintentional pharmaceutical drug poisonings” (overdoses). poisonings” (overdoses).

Highest Rx drug death rate in U.S., Highest Rx drug death rate in U.S., an increase of +250% over past two an increase of +250% over past two years.years.

Rx Drug Deaths in Lake CountyRx Drug Deaths in Lake County

Per the Ohio D.O.H: Lake County Per the Ohio D.O.H: Lake County would average between would average between 5 to 85 to 8 fatalfatal accidental drug poisoning per year.accidental drug poisoning per year.

(2000 - 2008)(2000 - 2008)

During the calendar year of 2010, During the calendar year of 2010,

2525 such deaths were reported to the such deaths were reported to the

LCNA by the L/C Coroner’s Office.LCNA by the L/C Coroner’s Office.

FACTFACT::

Per OSAM, (the Ohio Substance Per OSAM, (the Ohio Substance Abuse Monitoring program):Abuse Monitoring program):

““The misuse of Rx opioids & poly-The misuse of Rx opioids & poly-substance abuse account for substance abuse account for ~70%~70% of drug overdose deaths in Ohio of drug overdose deaths in Ohio while “street drugs, such as Heroin while “street drugs, such as Heroin and Cocaine, account for and Cocaine, account for < 30%< 30%” ”

20122012……

……as of December 31as of December 31stst of 2012, of 2012, twenty-twenty-eighteight “unintentional “unintentional fatalfatal pharmaceutical pharmaceutical drug poisonings” were reported to the drug poisonings” were reported to the LCNA by the Lake County Coroner’s Office.LCNA by the Lake County Coroner’s Office.

(An additional 6 similar deaths were (An additional 6 similar deaths were attributed to Rx drugs attributed to Rx drugs mixedmixed with Cocaine with Cocaine or Heroin, none by Cocaine alone, and an or Heroin, none by Cocaine alone, and an additional additional 4 deaths by Heroin alone4 deaths by Heroin alone.) .)

A QuestionA Question::

So why do regular people become So why do regular people become addicted to prescription drugs ?addicted to prescription drugs ?

Causes For An AddictionCauses For An Addiction

Unintentional addictionUnintentional addiction

A propensity for addictionsA propensity for addictions

Intentional or Unintentional Intentional or Unintentional MisuseMisuse

Intended outright abuseIntended outright abuse

Where Do The Drugs Come Where Do The Drugs Come From?From?

How do our family members, friends, How do our family members, friends, neighbors and colleges obtain neighbors and colleges obtain “abuseable” quantities of “abuseable” quantities of prescription drugs?prescription drugs?

Illegal Prescription Drug Illegal Prescription Drug Diversion; DefinitionDiversion; Definition

When otherwise When otherwise legallegal prescription prescription medications are obtained by medications are obtained by illegalillegal means. means.

To be abused, used and To be abused, used and misused outside of their misused outside of their intended medical purpose.intended medical purpose.

How Rx Drugs Are Most How Rx Drugs Are Most Commonly Diverted:Commonly Diverted:

““Doctor Shopping” (‘Deception to Obtain a Doctor Shopping” (‘Deception to Obtain a Dangerous Drug”, from a legal medical source)Dangerous Drug”, from a legal medical source)

Forging, Altering or Stealing prescriptions Forging, Altering or Stealing prescriptions (‘Illegally Processing” a Rx previously issued by a (‘Illegally Processing” a Rx previously issued by a

legal medical source)legal medical source)

Theft of the drug itself (From workplace, Theft of the drug itself (From workplace, neighbors, etc. or pretending to be a HCW)neighbors, etc. or pretending to be a HCW)

Buying them from a friend, associate, illegal or Buying them from a friend, associate, illegal or hostile sourcehostile source

““Doctor ShoppingDoctor Shopping””

Simply, lying to a physician, Simply, lying to a physician, pharmacist or any other health care pharmacist or any other health care provider who has control over the provider who has control over the prescribing or dispensing of a prescribing or dispensing of a dangerous drug, in order to obtain dangerous drug, in order to obtain that drug.that drug.

Illegal Processing, con’t…Illegal Processing, con’t…

Stealing, Possessing blank Stealing, Possessing blank prescriptions OR Creating them prescriptions OR Creating them yourself or having someone else do yourself or having someone else do it.it.

Altering or Forging any written Altering or Forging any written record, that is required by law to be record, that is required by law to be kept by a pharmacy, hospital or kept by a pharmacy, hospital or nursing home, etc.nursing home, etc.

Photocopying a PrescriptionsPhotocopying a Prescriptions… … (Don’t forget to take the original with you when you (Don’t forget to take the original with you when you

leave Kinkos or the post office!)leave Kinkos or the post office!)

Most Abused Rx DrugsMost Abused Rx Drugs:: 11stst:: Opiate analgesics / PainkillersOpiate analgesics / Painkillers

(Percocet, Vicodin, Methadone, (Percocet, Vicodin, Methadone, Fentanyl) Fentanyl)

22ndnd:: Benzodiazepines / SedativesBenzodiazepines / Sedatives(Valium, Xanax, Clonazepam)(Valium, Xanax, Clonazepam)

33rdrd:: Misc. Others, i.e. Ambien, SuboxoneMisc. Others, i.e. Ambien, Suboxone

44thth:: Alcohol + Poly-substance RxAlcohol + Poly-substance Rx drug misuse / abuse. (Accounts drug misuse / abuse. (Accounts

for the for the majority of accidental drug overdose majority of accidental drug overdose

deaths in Lake County)deaths in Lake County)

Street Prices of Rx DrugsStreet Prices of Rx Drugs

Per Per ONEONE Tablet: Tablet:

VicodinVicodin $3, $5 or $10$3, $5 or $10 MethadoneMethadone $5$5 PercocetPercocet $5 - $7$5 - $7 OxycodoneOxycodone $10 - $45$10 - $45 OxyContinOxyContin $40 - $75$40 - $75

Theft of DrugsTheft of Drugs

Physically stealing a drug from a HCF, Physically stealing a drug from a HCF, (hospital, pharmacy, nursing home, etc.) (hospital, pharmacy, nursing home, etc.) or from a person’s home, vehicle or purse, or from a person’s home, vehicle or purse, etc.etc.

Filling another person’s Rx without their Filling another person’s Rx without their knowledge or permission or “beating” knowledge or permission or “beating” another person to a pharmacy to deprive another person to a pharmacy to deprive them of their drug. them of their drug.

Illegal Diversion Penalties:Illegal Diversion Penalties:

If the “drug” involved is a If the “drug” involved is a prescription prescription drug of drug of any kindany kind, (from blood pressure , (from blood pressure medication to birth control to OxyContin), medication to birth control to OxyContin), illegal diversion automatically constitutes illegal diversion automatically constitutes a a 44thth or 5 or 5thth degree felony degree felony..

If the quantity of the drug involved is If the quantity of the drug involved is measured at, or exceeds, the “measured at, or exceeds, the “bulk bulk amountamount”, a felony of the ”, a felony of the first degreefirst degree may may have been committed. (Controlled Drugs)have been committed. (Controlled Drugs)

PENALTY TABLEPENALTY TABLE

OffenseOffense Min. TermMin. Term Max. Term Max. Term Max. Fine Max. Fine

F-5F-5 6 months6 months 12 months12 months $2,500$2,500

F-4F-4 6 months6 months 18 months18 months $5,000$5,000

F-3F-3 1 year1 year 5 years 5 years $10,000$10,000

F-2F-2 2 years2 years 8 years 8 years $15,000$15,000

F-1F-1 3 years3 years 10 years10 years $20,000$20,000

First Time OffendersFirst Time Offenders

Diversion to Municipal Courts for Diversion to Municipal Courts for Probation Consideration.Probation Consideration.

““Suspended” sentences / penalties at Suspended” sentences / penalties at the Common Pleas Level,the Common Pleas Level,

Probation Consideration,Probation Consideration, Substance Abuse Assistance,Substance Abuse Assistance, ““Leave It All Behind” Options.Leave It All Behind” Options.

L.C. Rx & OTC Drug “Turn-in” / L.C. Rx & OTC Drug “Turn-in” / Disposal ProgramDisposal Program

Run by the Lake County Health District Run by the Lake County Health District

Initiated late 2011 / ~ 4K lbs. collectedInitiated late 2011 / ~ 4K lbs. collected

7 residential drop-off / collection points.7 residential drop-off / collection points.

Final processing for weighing, statistics Final processing for weighing, statistics and disposal @ LCNAand disposal @ LCNA

Drop Box LocationsDrop Box Locations

1.1. Lake County Sheriff’s OfficeLake County Sheriff’s Office

2.2. Willoughby PDWilloughby PD

3.3. Willoughby Hills PDWilloughby Hills PD

4.4. Mentor PDMentor PD

5.5. Madison PDMadison PD

6.6. Eastlake PDEastlake PD

7.7. Lakeland Comm. Coll. PDLakeland Comm. Coll. PD

Contact InformationContact Information::

Sgt. Chris BegleySgt. Chris Begley

(440) 350-3337(440) 350-3337

chris.begley@lakecountyohio.govchris.begley@lakecountyohio.gov