Policing in the "OxyContin Epidemic"

[BadEnoughDudeRescueRonny]

As we all know, there's a huge surge in prescription drug abuse across the country, especially in Southwestern Ontario, with London and Windsor being major hotspots for opioid abuse.

OxyContin has hit this country like a plague and has impacted the medical and legal systems severely. Having worked Emerge before and having seen the overwhelming amount of oxy-heads that come in seeking narcs, having ODs and all other health issues related to drug abuse, it's incredibly apparent that we're dealing with something very real, and very serious. Seeing 19-20 year old kids covered with tracks to the point where they're mainlining into their neck is a terrible sign of the times. In my experience from Emerge, the severe OxyContin addicts are nearly as deranged as crack addicts, and are downright slimy, but then again, an addict is an addict.

I've spoken to more than a few police officers around here and there's a distinct feeling of frustration amongst them. They told me that they can only keep most OxyContin dealers in jail long enough for them to post bail and they're back on the street selling to more and more addicts. It's basically along the lines of the dealers giving the police the finger even after being busted. It's incredibly frustrating that dealers aren't remanded after arrest, regardless of what they're selling. Not only that, the amount of pharmacy robberies is skyrocketing as well as home invasions.

Anyways, my question is to all the police officers on the board. I ask, how has the OxyContin Epidemic changed your day to day duties and how has it impacted how you perform your police work? I'm under the impression that the oxy-head is a whole new breed of addict that requires a different approach to police work.

 

[Container]

It hasnt really changed things too much- its just the new drug that kids are destroying themselves with. There are always addicts and it seems like its always changing what the "it" drug is. But the courts are always behind- once they start handing out stiffer sentences for Meth the drug moves to Oxy's. Now the court doesnt treat Oxy as super significant yet- and by the time they catch up they'll be on to something else. Drug crime in Canada is never treated seriously by the courts- a friend of mine who works fed drugs out of toronto was saying that they make routine Khat busts of a couple hundred kilos and the importer will get a DAY A KILO. If they crown moves along with it at all.

The effect it has had is that there is an increase in pharmacy robberies and Ive noticed a slight increase in home invasions- and they are brazen ones where they obviously knew they were home. It used to be that they would B/E the place when they knew people are gone and now its more whenever they feel no matter whos present.

 

[The Bread Guy]

It hasnt really changed things too much- its just the new drug that kids are destroying themselves with.

Adults, too.

The effect it has had is that there is an increase in pharmacy robberies and Ive noticed a slight increase in home invasions- and they are brazen ones where they obviously knew they were home. It used to be that they would B/E the place when they knew people are gone and now its more whenever they feel no matter whos present.

A variation:  I've heard (second hand) of cases where someone holding an open house to sell their place has had OxyContin or OxyCodone stolen from their medicine cabinet.

Another factoid:  on remote First Nations, where alcohol is banned, oxy and similar drugs go for quite a bit - this from a First Nation police service in northern Ontario:

.... On April 29, 2011, police seized twenty-eight 60 milligram Morphine prescription pills with a northern street value of three thousand three hundred sixty dollars ($3,360.00) ....

That's ~$120 per pill - and when enforcement clamps down on supplies, I'm guessing that price'll go up pretty quick.

 

[Bruce Monkhouse]

I just posted on another thread a few days ago that, [my guess] about half of our inmates now are hooked on Oxy's.

It's time to start locking up *cough* medical professionals.  I mean they must have eyes and ears also, but I guess a big enough kickback  umm, I mean sales pitch, can make one blind and deaf.....................

 

[Container]

sorry I have a tendancy to lump every idiot under 30 as a kid.

Bottles of vodka in those ocmmunities go for 250 on a occasion. In the last place I was at since the court wouldnt send you to jail for bootlegging alcohol they just sold that. There was a surprising lack of drugs in the town. Low risk high profi booze bootlegging was good enough.

 

[GAP]

Hairspray was $75/can in Shamattawa when I was there....one of the PW engineers had a constant parade in to his motel room (mostly young girls)....his argument to the court....he was trying to help improve their self confidence by buying them makeup & hairspray.....yeah....the judge didn't believe him either....

 

[BadEnoughDudeRescueRonny]

It's time to start locking up *cough* medical professionals.  I mean they must have eyes and ears also, but I guess a big enough kickback  umm, I mean sales pitch, can make one blind and deaf.....................

I couldn't agree more. There's too many doctors out there that give ridiculously large prescriptions for oxys and do so on a regular basis and for no real reason. Basically, they're running pill mills and the College of Physicians and Surgeons is doing jack about it. By the time a crooked doctor gets his license pulled for running a pill mill, he's scripted thousands of pills. Even then, most times the College just gives a crooked doc a slap on the wrist, which really doesn't end up doing anything in the long run.

 

[mariomike]

Jul. 13, 2011
Ontario Coroner's Inquest:
"The 48 recommendations seek to change the way prescription opioids such as OxyContin are prescribed, policed and monitored.":
http://www.theglobeandmail.com/life/health/new-health/health-news/ontario-slow-to-act-on-prescription-drug-reforms-doctors-charge/article2095340/

 

[BadEnoughDudeRescueRonny]

Jul. 13, 2011
Ontario Coroner's Inquest:
"The 48 recommendations seek to change the way prescription opioids such as OxyContin are prescribed, policed and monitored.":
http://www.theglobeandmail.com/life/health/new-health/health-news/ontario-slow-to-act-on-prescription-drug-reforms-doctors-charge/article2095340/

The problem lies with the College of Physicians and Surgeons. They just don't regulate enough. In my research for my Master's, the general means of physician regulation is self-regulation based on a consensus model where the physicians offer advice/criticism to each other regarding their practice. The College is supposed to be the bureaucratized regulatory body for doctors, but they've been so slow to move on making any progress. In fact, I recall reading somewhere a statement from somebody in the College that opioid prescriptions are just getting a bad rap and that abuse and diversion was minimal. Clearly this clown was blind to the fact that there's tremendous over-prescription and diversion based on crooked doctors issuing massive prescriptions. There was one doctor in Southwest Ontario that got his license pulled and busted after he was eventually reported for writing scripts for OxyContin of something like 500 80 mg tablets at a time (Street value $20,000) on a regular basis for several individuals.

I've also heard of cases of crooked pharmacists and pharmacy techs dealing by using loopholes in narcotic medication logging.

The bottom line is that this drug has been a cash cow for anyone willing to sell their morals out. The bigger problem is that this drug can be obtained through legit means such as doctors and pharmacists.

While opioid pain medications are absolutely necessary in some cases, they need to be more carefully monitored and prescribed. There's been talk of narcotic medication tracking for years now, and nothing's been done. The government is really taking their time in resolving this issue and it's as though they're completely blind to the amount of damage that this drug is causing.

 

[mariomike]

TPH started handing out naloxone ( narcan ) kits a couple of months ago.

"Toronto Public Health's naloxone kit contains an antidote for overdoses of heroin, morphine, oxycontin and other opium-based narcotics.":
http://m.theglobeandmail.com/news/national/toronto/a-second-chance-for-overdose-victims/article2221828/?service=mobile

"The partner is also instructed to do chest compressions, roll the person on to their side to facilitate breathing, and call 911 – whether they stick around for the ambulance or not."

The results can be dramatic  :
http://www.youtube.com/watch?v=8xU_vcb3kso

 

[FlyingDutchman]

One of my family members has/had an Oxy problem.  The fights she had with he boy supplier (not really a boy friend) was rough from what I heard.  I would love a greater control of this drug.

 

[Cdn Blackshirt]

I just posted on another thread a few days ago that, [my guess] about half of our inmates now are hooked on Oxy's.

It's time to start locking up *cough* medical professionals.  I mean they must have eyes and ears also, but I guess a big enough kickback  umm, I mean sales pitch, can make one blind and deaf.....................

Starting point: 
1.  Annual prescription audit for each doctor.  Fines for providing false prescriptions at 10x billings earned.  Plus immediate 3-month suspension.  Plus the equivalent of rectal exam in following 24-months for all future prescriptions.
2.  Central registry for all medical charges and prescriptions per Healthcard Number so that doctors can identify if individuals are seeking and obtaining multiple prescriptions per drug.  Repeated attempts to obtain multiple prescriptions will result in blacklisting from system.


Bottom Line:  As you identify, until you make the "professionals" pay an inordinate penalty in comparison to the $ generated, they will not change their behaviour.


M.

 

[Bruce Monkhouse]

Actually I was chatting with a Doctor about this very problem [ because of a reason I can't get into] and he said that a lot of it is when the Doc tries to say no they become loud and aggressive and start causing a ruckas.
He said its just easier to give them what they LEGALLY want and get them out of the office.

 

[ModlrMike]

Actually I was chatting with a Doctor about this very problem [ because of a reason I can't get into] and he said that a lot of it is when the Doc tries to say no they become loud and aggressive and start causing a ruckas.
He said its just easier to give them what they LEGALLY want and get them out of the office.

An additional complication is that some of the more high functioning addicts will file complaints with the College. It takes a lot of time, energy and money to address a College complaint. Not to mention the added stress involved.

 

[GAP]

Starting point: 
1.  Annual prescription audit for each doctor.  Fines for providing false prescriptions at 10x billings earned.  Plus immediate 3-month suspension.  Plus the equivalent of rectal exam in following 24-months for all future prescriptions.

You'll catch the occasional stupid, careless one.....then they simply increase the documentation to account for it...right now it's easy peasy.............

2.  Central registry for all medical charges and prescriptions per Healthcard Number so that doctors can identify if individuals are seeking and obtaining multiple prescriptions per drug.  Repeated attempts to obtain multiple prescriptions will result in blacklisting from system.

that only works for those druggies that keep using their own name and card number.....
In actual fact, they switch identities with the same ease as you change the toilet roll.....(assuming you have no difficulties in that respect  ;D )

Bottom Line:  As you identify, until you make the "professionals" pay an inordinate penalty in comparison to the $ generated, they will not change their behaviour.


M.

 

[Fishbone Jones]

Actually I was chatting with a Doctor about this very problem [ because of a reason I can't get into] and he said that a lot of it is when the Doc tries to say no they become loud and aggressive and start causing a ruckas.
He said its just easier to give them what they LEGALLY want and get them out of the office.

Just a panacea of course, but targetted MDs make enough to hire off duty cops at their office. If they have problems with someone making a ruckus for drugs, let them pay for security.

Or pay the fines for prescribing them.

Arrest the perp and lock them away. No hug a thug or revolving door justice. Put them in jail long enough to make them go cold turkey and break the habit.

 

[MedCorps]

The risk (that I have seen happen in more than one civilian family practice / walk in clinic practice) is that the MD will stop prescribing narcotics leaving their patients in legitimate pain without pharmacological remedy.

For some of my colleagues / friends prescribing narcotics (because of the problems mentioned above, especially disruptive patients) has just not become worth it.  So they diagnose the patient and then refer them to a pain clinic (with long waiting lists), dump them on a specialist (with long waiting lists), send them to the ER for symptomatic relief (just adding to the burden of the already long line ups at the local ER), or prescribe non-narcotic alternatives which do not always work as well as the narcotics. If the patients bitches does not like this approach they are free to use another physician.... which is indeed the desired end state for the physician.

This is not good medicine, but if you make it a pain in the arse or costly to prescribe / administrate / manage then they just might get out of the pain relief business altogether.  This is messy if you are they guy who has just herniated a disc in your back and are in agony.

In Ontario in family practice if you see a patient and do a limited consultation for pain and prescribe a narcotic (complete with hassles) you get $65.90.  If you do a limited consultation for pain and refer them for someone else to deal with you get paid $65.90. 

Something to contemplate from the other side of the desk.

MC
 

 

[medicineman]

2 out of the 3 complaints I've already got against me so far were for not prescrbing narcotics (which beyond a couple of low level preps I can't do without the supervising physician anyway).  One we got a couple days after the fact, the other stormed out of the ER when I told them that the chronic pain issue wasn't going to get fixed there...

As for not being able to track the Rx, I think there must be a disconnect in Ontario with the rest of the country bumpkin provinces - my Dad was one of the original project managers for the Pharmalink system they use in BC - he helped write the program IN THE 1980's and we use a similar thing here in Manitoba.  It's a very good tool to have in the ER - especially dealing with drug seekers or even just folks that can't speak for themselves.  The only thing we had some issues with in BC was that any take away's given in the ER weren't recorded...however, we could link into the electronic charts of any ER with the Vancouver Island Health Authority and check if they'd been ER hopping.  If they stop giving much more than a dose in the Dept and then send them away empty handed, word will eventually get around.  When I was training in Dauphin, the Parkland Regional Health Authority, along with most of the other RHA's acutally went so far as to ban the stocking/dispensing of Demerol in the ER's, as it was a drug of choice to come looking for.

If people are concerned about health care fraud, start actually putting people's photos on the care cards and having to provide some sort of proof of identity to get them - intial outlay may be expensive, but oh well...when the same digital photo appears with different names/numbers in the system, they'll get found out.

And as MedCorps said, be careful what you wish for - you might find yourself gibbled up somewhere demanding some pain meds and find yourself being rolled out the door by the off duty cop lounging in plain clothes in the waiting room...if you folks want the real solution, start lobbying the drug companies to come out with more/better painkillers that work without making someone stoned, overly happy and dependant.  :2c:

I'll leave things there for now...I sense a rant coming on.

MM