Feds step up drug enforcement of pharmacies
On July 13, 2012, a pharmacy technician ordered 1,000 hydrocodone pills through the San Diego pharmacy he worked for.
But it was not a sanctioned order. The highly addictive drugs were either meant for his own consumption, or to restock the pharmacy’s supply of pills he had already stolen, concluded the state Board of Pharmacy, which ultimately revoked his license after he was convicted of prescription forgery and burglary.
The incident helped spark a massive investigation into Medical Center Pharmacy, a collection of a dozen family-owned pharmacies that operate throughout San Diego County. What the U.S. Drug Enforcement Administration found was a system that lacked controls on the distribution of controlled substances, shoddy record-keeping and lax procedures on dispensing psuedophedrines, which can be used to make methamphetamine, the U.S. Attorney’s Office announced this month.
The investigation also found a total of 21,000 oxycodone and hydrocodone pills that were unaccounted for from four San Diego pharmacies over a two-year span. In some instances, the drugs are believed to have been delivered to a home used by pill seekers, authorities said.
The effort to combat the illegal flow of pharmaceuticals from legitimate businesses is intensifying as prescription drug abuse remains a top public health concern.
The DEA, which enforces pharmacy compliance with federal drug laws, has increased the amount of surprise inspections on businesses in recent years. And the state board that licenses pharmacists and similar workers is considering making it mandatory for pharmacies to inventory their drug supplies once every quarter to better stem the illicit flow.
Pharmacies are currently required to report when drugs go missing. Last year in California, 1 million dosages of pills were reported lost, said Virginia Herold, executive officer of the state board. The year before it was about 1.5 million.
“The problem is controlled substances are so valuable on the street compared to their value in the pharmacy,” Herold said. Some pills go for $30 each or more, she added.
Employees who divert pills are either addicted to the drugs themselves, or just selling them for the money, said DEA Supervisory Special Agent Thomas Lenox.
Besides pill diversion, other major problems that authorities look for is poor record keeping and pharmacists who are more focused on filling a prescription rather than doing their due diligence to make sure the prescription is legitimate and not stolen, forged or counterfeit.
“The one thing is, it’s all paper,” Lenox said of the stringent record keeping required of pharmacies. “You either have the documentation or not. If you don’t have them, you’re in violation.”
Investigators say the problems are seen just as much at large, chain pharmacies as at smaller mom-and-pop pharmacies. The only difference is volume: Missing pills are also sometimes spotted faster at the larger chains due to more stringent corporate policies in place, Herold said.
Earlier this year, CVS Pharmacies and the U.S. Attorney’s Office entered into a $22 million settlement after an investigation showed some pharmacies in Florida were knowingly filling illegitimate prescriptions for painkillers.
Authorities can go after offending pharmacies in various ways, from sending a letter of admonition to taking away the DEA registration that allows them to sell controlled substances to civil enforcement to criminal charges. The state board can also go after licenses of individual workers. Licensed workers do undergo background checks, Herold said.
In the Medical Center Pharmacy investigation, authorities went the civil enforcement route, resulting in a $750,000 settlement last week. The corporation, owned by Joseph and John Grasela, operates several storefronts under names such as Galloway Medical Center Pharmacy, Community Medical Center Pharmacy and Medical Center Pharmacy.
Besides the missing pills, authorities said the pharmacies also violated the Combat Methamphetamine Epidemic Act, which requires pharmacies to keep a logbook of sales of certain over-the-counter medications that can be used to make meth. The records must include the buyer and the product purchased, and are intended to prevent individuals from buying large quantities of the same drug.
The pharmacies have had problems with the board before, Herold said. As part of the settlement, the owners have agreed to implement new inventory control measures, authorities said.
This case is just the most recent example of similar pharmacy misconduct in the county.
Last year, a Hillcrest pharmacist lost her Sixth Avenue Pharmacy over allegations of failing to account for 16,000 missing oxycodone pills, dispensing drugs with invalid or nonexistent prescriptions, exchanging drugs for services or advancing pills to customers, according to the U.S. Attorney’s Office.
In 2008, federal agents raided three San Diego pharmacies on allegations that several employees were diverting painkillers.
The DEA works closely with the pharmacy board to educate pharmacies on drug trends, how to spot theft, and security measures such as surveillance cameras, keeping addictive drugs under lock and key and keeping stocks of such painkillers low.