Busting an OxyContin ring: Part 1
This is Part 1, because the investigation is ongoing, and we really don't know how deep the rabbit hole goes, so-to-speak. I suspect when all is said and done, we'll be looking at several hundred thousand dollars (street value) of illegally-gotten OxyContin, if not in the millions.
For those of you that don't know, OxyContin has a street value of about $1 per milligram. That means an 80mg tablet is worth $80 on the street. That means a bottle of 100 is worth… $8000. A bottle of 100 80mg tablets costs just over $1,000 at full retail pharmacy price.
The beginning
Several days ago, someone brought in a prescription for 3 different strengths of OxyContin. This isn't terribly unusual for our pharmacy. However a check of his profile noted that he was a bit early. And he had been coming a bit early nearly every time he got his scripts filled for the past few months. As we've had some CII shenanigans in the last few weeks, enough was enough. We filled them, let him buy them — name-brand, of course — paid in cash.
Today we decided to do a little homework. We called the office of the prescriber (an NP), and after an interesting conversation with the office staff, we find out that these scripts are all forgeries. Pretty good ones.
We pulled all of the hard copies of his prescription history for CIIs. All of them forgeries, because he hasn't been seen at that office in months. Our pharmacy initiated a PharmAlert for our state, regarding this person and forged prescriptions. We also got the police and the DEA involved. The guy is good. He comes in with a cane and limp, and he's very polite. He does have the annoying habit of leering over the counter while you type the script in, but so do a lot of people. More on this below.
Today
Our pharmacy had been in contact with the police regarding this person today, before I got to work. Turns out he got 1000 tablets of OxyContin (of varying strengths) filled at a Wal-Mart in the same town last week. That means he's filled somewhere around ~1200 tablets of OxyContin in the last ten days. We didn't know this until after what happened below:
We had another person come in today. Another OxyContin prescription allegedly written by the same prescriber. Of course we were suspicious, so I called the office, and asked whether they had a patient by the name of X on file, and when had she been seen last, etc. Turns out they didn't have Ms. X on file at all. Searching by name, date of birth, every thinkable combination. Nothing.
Another forged prescription.
We called the police again. Specifically the guy who's been handling the previous forgeries in the last 24 hours. He's really interested now, because she's left to do a few errands and will be back in about a half hour. Well it's really busy and I'm fielding doctor calls and voicemails and drug questions, a tech is ringing people out, and my boss is dealing with an irate customer. This is all going on when she comes back. I phone the police again and let them know that she has arrived and they ask me to stall her.
Okay, no problem. It's so damn busy we don't even have to pretend like nothing's going on simply because this is a normal day at the office, so to speak, legitimate issues from every direction, especially since we're short-staffed for the volume we were doing today. (Pharmacy is a very interrupt-driven job — you rarely get anything done without being interrupted at least once.)
Anyway, the police arrive within five minutes(!). They arrest the woman, and start collecting housekeeping information. I was actually pretty impressed with how quickly and quietly they took her out. Not even the store manager noticed. Photocopies are made, smalltalk is done, then it's back to business as usual: playing catch-up with the queue because all of the goings-on have put us behind.
Officer Narc
The officer, who I assume is in charge of narc stuff in our town stops by for a chat several hours later. He has the paperwork from Wal-Mart and he goes over it with us. The forgery guy from yesterday is crazy. I've never seen anything like what was dispensed at Wal-Mart. (Why no warning flags? I don't know. Hello, 1,000 tablets? Maybe I don't have the whole story yet.)
He tells us that they woman they arrested 2 hours earlier has been bailed out of jail. All she told them is that she bought the prescription from someone in the town I live in. (I work in a different state.) So this goes way deeper than isolated incidences. We're talking federal offences here in two different states totalling hundreds of thousands of dollars of forged prescriptions, just from this one guy.
This is going to be huge for the town I work in. My boss and I are brainstorming, trying to think of some of the other patients that have allegedly had prescriptions by this provider while Officer Narc is there. He's pretty chill, shooting the breeze with us. I come up with a few more names, we start talking about bad doctors as well. (Another story for another day.) He's loving it because this is potentially adding up to be the biggest drug bust this town has seen in recent history. Possibly ever.
Then my boss has the braindead obvious idea to call the LP guy for our district. He can actually query the central database and get a list of all of the prescriptions supposedly written by this NP for all the stores in the region. And he loves this stuff. I can't wait to hear what he turned up.
Trouble down the street
Time for the changing of the guard. The night pharmacist comes in from down the street where she'd been working earlier in the day. We tell her about the shady forgeries and she tells us the guy's name before we can even tell her who it is. Oh really? Interesting. Forged scripts being filled down the street as well at her pharmacy. She even knows the prescriber on them. In fact, he'd been down the street just today, filling Percocet. That will initiate a PharmAlert for that state as well.
So it's looking like this is bigger than we thought when we first started asking questions. Someone is apparently selling these prescriptions, and I'm not surprised. Anyone with a small amount of pharmacy knowledge and a working knowledge of Word could create these scripts in about 20 minutes. Most of that time spent getting the spacing looking right.
However we're wondering if it's an "inside job." Is someone in the NP's office supplying these phony scripts to someone else who's selling them? We don't know. But I have a feeling we'll be finding out in the next month as things become more untangled and the picture becomes clearer.
Heh, I expect there to be big announcements from all of the law enforcement agencies and both state polices in the area when all is said and done. Right now we're looking at several hundred thousand dollars just from this one guy. (The woman that was arrested was small potatoes in comparison and likely only had a drug habit rather than selling them.) I'm sure there are others, especially if you can buy these scripts from someone in my town.
[tags]Medicine, pharmacy, law enforcement, OxyContin[/tags]
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Fascinating
It's a pity that pharmacies can't cross-check each other easily to ensure that someone isn't doing that.
Comment by Duncan Hill — July 11, 2006 @ 8:09 am
Wow, this is awesome — I'm going to cross link this post on my journal; most of my readers are in biotech and may like your blog in general, with this entry in specific.
Comment by DrFaulken — July 11, 2006 @ 9:14 am
[...] has got to be one of the most fucked up days on the pharm on record. Possibly even weirder than the OxyContin bust [...]
Pingback by “Wanted by police” :: OnThePharm — April 26, 2007 @ 10:53 pm
i think every state needs to implement the scripts like jersey uses the blue, all the same federally regulated, water mark.. the whole 9. It doesn't eliminate this problem but it greatly reduces it. I stopped filling rx's that i didn't verify if patient was paying cash. I did about 300 a day too but it was worth it.
Comment by kp — June 19, 2007 @ 10:44 am