DEA Aims to Stem Painkiller Black Market

DEA agents are targeting the top of the supply chain as part of a comprehensive strategy to stop the flow of prescription drugs to street dealers.

Vincent Moellering heard a rumor in April 2009 that a local pharmacy was selling the powerful and addictive painkiller oxycodone by the pill for cash. So Moellering, an investigator for Cardinal Health, one of the nation's largest distributors of pharmaceuticals, visited Gulf Coast Medical Pharmacy in Fort Myers, Fla.

Over the next two years, Moellering and other Cardinal employees visited that pharmacy at least four more times. Each time, they noted disturbing signs: Customers paid cash, oxycodone was the No. 1 seller, and young people came in groups to have their prescriptions filled.

On Oct. 5, 2010, Moellering's fourth visit, pharmacy owner Jeffrey Green told him he wanted more oxycodone. The store had dispensed 462,776 pills over two months -- nearly seven times what the average pharmacy dispenses in a year. Convinced something was off, Moellering asked Cardinal's permission to contact the Drug Enforcement Administration, according to documents filed in federal court.

The DEA says the call never came. Cardinal would not make Moellering available for comment and declined to explain why he never made the call. Cardinal granted Green's request for more oxycodone but stopped serving the pharmacy a year later.

This month, the DEA accused Cardinal Health, a Fortune 500 company with $103 billion in revenue, of endangering the public by selling excessive amounts of oxycodone to four Florida pharmacies. The charges came in an immediate suspension order served Feb. 3 when the agency suspended Cardinal's license to distribute controlled substances from its Lakeland, Fla., hub, which serves four states.

Cardinal challenged the suspension in federal court. U.S. District Judge Reggie Walton temporarily halted the DEA's suspension and scheduled a hearing for Wednesday. In preparation for the hearing, the DEA and Cardinal have filed hundreds of pages of documents that provide an inside look into how prescription painkillers such as oxycodone and hydrocodone have flooded the black market.

The investigation into Cardinal led the DEA to suspend the licenses of four of the company's largest Florida customers, including Gulf Coast and two CVS pharmacies in Sanford, Fla. Like Cardinal, CVS challenged the suspensions in federal court.

The suspensions are an aggressive display of the DEA's strategy to attack the prescription drug abuse problem at the highest levels. After years of cracking down on doctors who dispense drugs from clinics known as pill mills, DEA agents are targeting the top of the supply chain as part of a comprehensive strategy to stop the flow of prescription drugs to street dealers.

More than 5 million people in the USA abuse narcotic painkillers. The Centers for Disease Control and Prevention classifies prescription drug abuse as an epidemic. More than 27,000 died from prescription drug overdoses in 2007, a fivefold increase since 1990, which parallels a tenfold increase in the medical use of painkillers such as oxycodone and hydrocodone, the CDC reports.

"The number of overdose deaths involving prescription pain medication is staggering and now exceeds deaths from heroin and cocaine combined," said Gil Kerlikowske, director of the White House Office of National Drug Control Policy. "Just because prescription painkillers aren't sold out of a piece of tinfoil by a drug dealer lurking in a back alley doesn't mean they're not dangerous."

Kerlikowske said the federal steps to control the epidemic are mindful of the need to protect access to the medications for legitimate patients.

Doctors prescribe oxycodone and hydrocodone to treat severe pain after surgery or during cancer treatment. Doctors also use the drugs to treat people with illnesses and injuries that cause chronic pain. Hydrocodone is nearly as potent as morphine for pain relief. The drugs -- synthetic versions of the compounds found in opium -- are highly addictive and can produce a heroin-like high. Drug abusers may crush the time-release tablets and inject or snort the medicine to get the most potent high. People who consume too much of the drug may have trouble breathing, slip into a coma or die.

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