Prescription Drug Abuse
Analysis of Florida Times Union Article
August 4, 20001
On August 4, 2001 R. Michael Anderson wrote an article for the Florida
Times Union <go
to the original articles> about prescription drug abuse and
resulting prescription medication fraud. The article attempted to
summarize the tactics used by prescription drug addicts to fraudulently
obtain prescription drugs and to discuss the costs of prescription drug
abuse to society. The article was incomplete, so I decided to follow
the format of the article, remove the unnecessary anecdotal examples, and
present a more accurate analysis of the problem.
Prescription drug abuse is a serious problem that can destroy families,
claim lives, and costs billions of dollars annually. Until
recently the war on drugs has ignored prescription drug abuse, but
beginning in 2000 they began gearing up for a national offensive on
prescription drug abusers. The primary target in this front in the
war on drugs medication fraud, the crime c0ommitted by prescription drug
addicts when they report false information or actually forge prescriptions
in order to get the medication that they are addicted to.
Although prescription drug abuse is primarily a medical problem that
should be addressed by a public health addiction policy, the DEA and other
aspects of law enforcement want to bring the full force of law to bear on
people addicted to prescription drugs and the physician and pharmacists
who intentionally or unwittingly provide those medications. So the
war on drugs focuses upon prosecuting prescription fraud and drug law
violations rather than educating the public physicians and pharmacists
about the nature of prescription drug addiction, how to intervene in a positive
way that will result in prescription drug addicts seeking treatment, and
investing to make community based treatment resources readily available.
Prescription fraud is a crime that is usually committed by people who have
become addicted to prescription medication and then have their supply cut
off without being referred to treatment. The addicts untreated
addictive thinking rationalizes the exaggeration or fabrication of symptoms,
seeking drugs from many doctors at the same time, and using fraudulent
prescriptions, often created by altering the quantity of number of
Anderson's article focused exclusively upon the criminal aspects of
prescription drug abuse while ignoring the need to identify and intervene
upon the underlying addictive illness that creates the need to commit the
Most people who commit prescription medication fraud are law-abiding citizens who wouldn't commit
any other crime. They are driven into prescription fraud by an
addiction which is usually unrecognized by their physicians and even if it
were recognized, it is unlikely that proper treatment would be unavailable
because most of the war on drugs money is going into enforcement while
treatment recourses are being down-sized or eliminated.
The most common illegal acts, arranged in the order of frequency, used
to acquire prescription drugs through fraud are;
Exaggerating or Fabricating Symptoms: Presenting exagerrated
or fabricated symptoms to a Doctor in efforts to convince them to
prescribe more drugs or stronger drugs than are necessary. (This is,
by far, the most common form that prescription drug abuse takes.)
Physician Hopping: Seeing more than one physician at a
time and asking each to prescribe the same medication. This is often
called physician hopping.
Diversion of Legitimately Prescribed Medications: Many
addicted people will offer to buy medication from patients who are
receiving legitimate prescriptions for the medication. This often
happens because many seriously ill pain patients are unemployed and in
desperate need of the cash that selling their medications can provide.
Forging Prescriptions: Steal prescription pads from medical offices and forge
Fraudulent Calls To Pharmacies: Telephoning pharmacies claiming to be a
physician or an assistant requesting drugs for a patient.
Theft: Robbing or burgalrizing pharmacies tpo steal the
Low Level Drug Transactions: Some people will buy, sell, and
trade prescription drugs which is a technical violation of felony drug
laws. There are few "big time" dealers involved in the
prescription drug trade.
The prescription drugs that are most commonly abused are the Opiate-based drugs such as:
The costs that occur as the result of prescription drug
addiction. These are:
pain and sufferring of the addicted people and their families.
This includes not only the anguish caused by the addiction itself but also
the harsh punishments imposed as our nation's drug warriors crack down and
begin imprisoning addicted people for using and low level distribution of
Increased insurance Costs: Increased insurance costs as a result
of excessive doctors visits and excessive use of medication benefits that
are passed on to all consumers. No estimates were reported
indicating what that cost might be
Increased Crime: Increased crime in the form of various aspects
of prescription fraud including burglary, theft, and diversion of
Increased Cost Of Enforcement: As the DEA is cracking down on
prescription drug abuse large amounts of money are spent in investigative
work with known prescription drug abusers, pharmacies, and
physicians. These investigations are typically targeted on the
addicted users who are often small time dealers supporting their personal
Lost Productivity Due To Criminal Justice Actions: Most
prescription drug abusers are employed. When arrested for
prescription drug abuse many are terminated from their jobs and have
difficulty finding new employment.
Costs of Incarceration & Criminal Justice Monitoring:
Many prescription drug abusers are arrested, prosecuted, and sentenced for
drug crimes surrounding their prescription drug addiction.
Some enter court diversion programs and receive treatment in the community
while being supervised by drug courts and/or probation departments.
Others are incarcerated in jails and prisons.
The costs involved in increased enforcement, lost productivity
due to criminal justice actions, and the costs of incarceration and
criminal justice monitoring could easily exceed all other cost factors
involved in prescription drug abuse.
Clay County Florida provides atypical example of how law enforcement is
organizing to combat prescription drug abuse. To crack down on the problem, the sheriff's office has:
Assigned an investigator full time to prescription drug abuse cases
Initiated a drug court to keep offenders out of jail but under close supervision while they go through a one-year program that
involves counseling, frequent drug testing and regular court appearances.
Launched intensive investigations to identify prescription drug addicts
and the physicians and pharmacies that provide them with their
drugs. this has involved having investigators visit each individual
pharmacy and attempting to enlist the pharmacist as informants about
people who might be abusing prescription drugs.
Asking pharmacists to require photo identification from everyone with a
Asking pharmacists to keep doctors' signatures on file to compare with signatures on
Calling physicians to verify prescriptions
Securely dispose of all paperwork containing patient information
Calling police if they think someone has submitted a phony prescription.
So, what is a pharmacist supposed to do if they suspect someone of
prescription drug abuse.
Step 1: Call the physician's office to verify the prescription
Step 2: If the prescription cannot be verified, don't fill it
Step 3: Explain the problem to the customer and ask them to talk
with their physician.
Should a pharmacist call the police? If the pharmacist is not in
danger and the amount is obviously for personal use, I'd say
Ideally pharmacists and physicians should be trained in medical
interventions that could use the identification of an attempt to get a
prescription refilled too soon or to get a fraudulent prescription filled
as an opportunity to get the addicted person into treatment for their
As things stand it's up to the individual pharmacist whether to send the person
asking for the prescription on his way or try to stall him and call police.