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A prescription for trouble

Police, doctors, pharmacists say prescription drug abuse is on the rise

December 17, 2011
By CHRIS KNIGHT - Senior Staff Writer ( , Adirondack Daily Enterprise

SARANAC LAKE - Two years ago, the Franklin County Drug Task Force received a tip that a house in Malone was being used as a trafficking center for prescription narcotic drugs.

"It was a house that had nonstop traffic," said Franklin County District Attorney Derek Champagne. "It came to the attention of neighbors as well as law enforcement, and we were able to purchase a number of prescription drugs out of the house (through a police informant)."

But this wasn't just a run of the mill drug house, the DA said. Police set up a wiretap of the house's phone lines and learned that these dealers weren't just doling out drugs, they were also passing along advice.

Article Photos

Bottles of hydrocodone, a prescription narcotic that’s often abused, sit on a shelf behind the counter at Kinney Drugs in Saranac Lake.
(Enterprise photo — Chris Knight)

"The phones were basically nonstop instructions to people on which doctors to go to, how to go to different pharmacies, and what to say to which doctors to get hydrocodone and oxycodone," Champagne said.

The extent of the operation surprised law enforcement, but in retrospect, it was just another sign of a growing problem across the North Country: the abuse of prescription narcotic drugs. Police, prosecutors, doctors, pharmacists and drug counselors say narcotics like OxyContin, Percocet and Fentanyl have become the drug of choice for many people.

"I would frankly call it almost an epidemic," Champagne said. "There's been just a tremendous surge in the buying and selling of prescription drugs by people that previously would have been dealing with cocaine or heroin or marijuana."


Signs of a problem

Over the course of two weeks in November, the Essex County and Franklin County drug task forces arrested more than 20 people in two separate county drug sweeps. Most of the defendants were charged with criminal sale and criminal possession of controlled substances, like hydrocodone, morphine and fentanyl.

"I think it's probably rising faster than anything in our line of work," said Lt. Brent Davison of the state police Troop B Bureau of Criminal Investigation. "Over the last 10 years there's been a gradual climb, and in the last two years it's climbed dramatically. Not only do you have the unlawful sale and distribution of these prescription pills, you also have people who are addicted to them who are committing crimes."

In Saranac Lake, village Police Chief Bruce Nason told the Enterprise this week that prescription drug abuse has been a factor in 27 percent of the arrests made by his department so far this year.

But it's not just police who are seeing this trend. Melinda Drake, outpatient services director for St. Joseph's Addiction Treatment and Recovery Centers, said more and more people are being admitted into St. Joe's outpatient clinics because they're addicted to prescription narcotics.

"Across our system, what we're seeing from 2009 to now is a doubling of the number of clients coming in and being admitted with prescription drug abuse as their primary addiction," Drake said.

Doctors and pharmacists are seeing the same trend. In fact, they're the ones on the front lines, dealing with people who are trying to illegally obtain prescription narcotics, often through lies and subterfuge.

"We hear a multitude of excuses," said Chuck Dilzer, pharmacist at Kinney Drugs in Saranac Lake. "Some of the things that tip us off are people who come in and say, 'I need an early refill; I'm going out of town' or 'I lost my medicine' or 'My girlfriend and I broke up, and she ran away with my stuff.' There's a lot of bobbing and weaving that goes on."

At Adirondack Medical Center in Saranac Lake, Associate Emergency Department Director Dr. A.J. Dowidowicz said he was "astounded" by the extent of the problem after coming here from New York City last year.

"What was striking about coming up here was people are using the health-care system to get 'legitimate prescriptions' for drugs to enable their habits," he said.


Easy to obtain

Asked why prescription drug abuse has spiked, Champagne said it's primarily because these kinds of medications are easy to come by. Large quantities of prescription narcotic pills are being smuggled into the North Country from Canada where people can buy them on the street. Or people can steal them from a family member's medicine cabinet or obtain them by "doctor shopping" at physicans' offices and emergency rooms around the region.

"Some people have it down to a science," Champagne said of the latter group. "There's this group that's become so good at pulling the wool over people's eyes."

Jennifer Smith is one of those people. A former registered nurse from Port Henry who battled prescription drug abuse for 20 years, Smith told the Enterprise (See Page B1 of today's Enterprise) that she would doctor-shop at hospitals and medical facilities across the region.

"You'd make up an issue they couldn't prove like, 'Oh, my lower back is hurting,'" Smith said. "You can't really prove that, so they give you medicine to make you feel better. You'd go from doctor to doctor. I went from Ticonderoga up to the Adirondack Medical Center (in Saranac Lake) to the hospital in Burlington. I went all over the place, making up things."

Dowidowicz said the addicts that come to the AMC ER are seeking either prescriptions, which they'll fill at area pharmacies, or intravenous narcotic drugs. Part of the problem, he said, is that they've often got what they wanted, with not enough questions asked by medical personnel.

"Going back through their records I was surprised to find that historically people had been very liberal with the way they prescribe drugs, some older practitioners more than others," Dowidowicz said. "In some way, the health-care system has sort of created this problem over time."


The users

Who are the people that are abusing these drugs?

"We're seeing every extreme," Champagne said. "We're seeing the housewife, the professional, the unemployed, the students."

Representatives of North Star Behavioral Health Services told the Saranac Lake school board in October that they've seen an "uptick" in prescription drug abuse in local schools.

"What we'll find is kids will progress rapidly into a dangerous place, more rapidly than we've ever seen before," North Star's Beth Lawyer told the board.

Champagne said he's heard of high school and even junior high kids having pill parties.

"Everyone says 'Hey grab a couple pills out of your parents medicine cabinet,' and they put it in a bowl and they take it," he said. "You may as well have a loaded handgun sitting in your medicine cabinet because the potential for harm, for overdose or something terrible to happen is truly there."

Many of the adults that are using prescription drugs don't have health insurance to pay for these prescriptions. That means they're either paying out of pocket or using public assistance, like funds from Medicare or Medicaid.

In one such case, Dilzer said a local woman was arrested three months ago in Saranac Lake after she overdosed on drugs and was found passed out in her car near an intersection, with a small child in the back seat. Before she went to court, police asked the pharmacy to run a statement of what medications she had obtained.

"Going back to 2008, there's like $26,000 worth of Medicaid billed medication that who knows whether she even used it or sold it or who knows," Dilzer said. "We're all paying for that because it was all on Medicaid."


Health effects

What impacts can these drugs have when they're taken in excess?

"You can cause everything from severe constipation to making yourself totally incoherent to respiratory suppression to the point where you might end up in the ER or dying," Dilzer said. "There's a broad range of effects based on the dose and your narcotic tolerance."

Davison said nine deaths have occurred in Troop B over the last two years that were directly attributed to the overdose of prescription medications.

Franklin County Chief Assistant District Attorney Jack Delehanty said he knows of six cases in the past year where people were found slumped over the wheel of their car at an intersection, passed out from drug abuse.



Asked how the problem can be curbed, most people interviewed for this story say it's up to doctors and medical practitioners to be more vigilant about prescribing narcotic drugs.

"I think what's happening is when you have clients going from one doctor to another doctor to another doctor, none of the doctors know what the other doctor has prescribed them," Drake said. "Before you know it, they have so many prescriptions for a certain medication that you're seeing a pattern of addiction. Until people share that information, it's very hard to address that problem of access."

Delehanty said there needs to be a central computer database that keeps track of all these regulated controlled substances "so you can see what is being prescribed to these people in real time."

But sharing that kind of information isn't easy these days, Delehanty said, given federal laws like HIPAA that are designed to protect a patient's privacy.

"I think it's a legal quagmire now," he said.

Champagne said his office worked with the federal Drug Enforcement Adminstration and identified two doctors in the county who were prescribing high amounts of narcotic drugs, in comparison to other doctors.

"We talked to them and we told them people that were targets of ours, people we believe might be going to them. We told them to ask the additional questions or be more vigilant.

"It is a complex issue we're making a lot of inroads on, but I think a huge concern is how many people out there are currently addicted to these prescription drugs."



Dilzer said there are many people who have legitimate medical reasons to be prescribed narcotic drugs; doctors and pharmacists don't want to prevent them from getting help.

"But you don't want things to spiral out of control," he said. "We just have to take the time to pay attention and pick up on these things."

Dowidowicz said AMC plans to reach out to people who frequently come to the ER with unspecified painful conditions like chronic migraine headaches and chronic back pain and ask what can be done to help them.

"I think we need to be more aggressive and reach out to people who truly need our help," he said. "By engaging patients in that way it will build better relationships with them. People who simply don't want the help, they won't respond. But if their answer to us is that is they need detox and rehab, that's very legitimate. That's what we're there for."



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