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“Opioids and Law Enforcement: Responsible Prescribing”James B. Embree, MA
POMA District VIII 31st Annual Educational Winter SeminarJanuary 25‐28, 2018 1
Responsible Prescribing
James B. Embree, BA, MANarcotics Agent II
Pennsylvania Office of Attorney General
A Law Enforcement Perspective
AGENDA FOR TODAY
Red Flags•Law Enforcement
DoctorsNurses
•Co-workers•Health Professionals
“Opioids and Law Enforcement: Responsible Prescribing”James B. Embree, MA
POMA District VIII 31st Annual Educational Winter SeminarJanuary 25‐28, 2018 2
RED FLAGS FOR LAW ENFORCEMENT
Prescribing more than 1 immediate release and 1 time release opioid
Overlooking urine or blood screen results
Failing to establish or failing to maintain a doctor/patient relationship
Treating patients with drug convictions
Accepting cash knowing that the patient is covered by insurance
RED FLAGS FOR LAW ENFORCEMENT
Doctors with reputations as “Easy” or “Pushovers”
Meeting patients outside of the practice etc.
Charging by the Rx instead of by the visit
Over Looking or Ignoring PDMP
RED FLAGS FOR LAW ENFORCEMENT
Prescribing Opioids to Drug Dependent Patients
Pre Signing Prescriptions Failing to Keep and Maintain Records
“Opioids and Law Enforcement: Responsible Prescribing”James B. Embree, MA
POMA District VIII 31st Annual Educational Winter SeminarJanuary 25‐28, 2018 3
RED FLAGS FOR LAW ENFORCEMENT
Nurses/staff stealing from patients or hospital medical carts
Nurses with higher than average wasting habits
Nurses with higher PRN administering
Nurses with poor documentation
Nurses that access the machines without documentation of withdraw
DONNA MOONDA INVESTIGATION
“Opioids and Law Enforcement: Responsible Prescribing”James B. Embree, MA
POMA District VIII 31st Annual Educational Winter SeminarJanuary 25‐28, 2018 4
POSSIBLE PENALTIES
Loss of Nursing license for minimum 10 years Loss of medical license for minimum 10 years Loss of pharmacy license for minimum 10 years Felony drug conviction on record
POSSIBLE PENALTIES
Jail time or probation for multiple years Seized assets such as cars, money, etc. Public embarrassment
RED FLAGS FOR CO -WORKERS
Nurses with poor documentation Nurses offering to handle narcotics
counts by themselves Nurses asking you to initial a waste that
you did not witness Nurses asking to use your password Mood swings High call off rates
“Opioids and Law Enforcement: Responsible Prescribing”James B. Embree, MA
POMA District VIII 31st Annual Educational Winter SeminarJanuary 25‐28, 2018 5
RED FLAGS FOR CO-WORKERS
Patients complaining of pain after documentation of administering on MAR or PRN sheets
Frequent breaks Nurses or Doctors that appear impaired
RED FLAGS FORHEALTH CARE PROFESSIONALS
Drug Seekers Patients who manipulate quantity,
dosage units, brand, drug Groups or multiple family
members Lost or stolen RXs Patients with insurance requesting
to pay cash Out of state or travelling great
distances
3 month investigation 4 search warrants 22 Doctors/Dentists 14 Pharmacies 6 Patient Profiles 5,000+ Norco/Vicodin 1 arrest
VIDOVICH INVESTIGATION
“Opioids and Law Enforcement: Responsible Prescribing”James B. Embree, MA
POMA District VIII 31st Annual Educational Winter SeminarJanuary 25‐28, 2018 6
2 month investigation 4 search warrants 2 consent searches $388,000 6 firearms 3,000+ Oxycontin 5 arrests
DOYLE INVESTIGATION
CONTACT INFORMATION
PA Office of Attorney General 105 Independence Lane Butler Pa 16001724-284-3400
Request Diversion Unit
