Drug Diversion and Abuse: Staring Down the Barrel

Author: Cmdr John Burke


The author highlights the book Staring Down the Barrel, which addresses the growing concerns and problems facing everyday pharmacists as they are confronted by prescription drug diverters and armed robbers.
Staring Down the Barrel is a book unlike any I have seen on the market. It specifically addresses the concerns and problems facing everyday pharmacists as they are confronted by prescription drug diverters and armed robbers. This problem has grown over the past decade or so, and unfortunately in some cases, it has caused the death of both pharmacy employees and customers—most of whom were simply complying with the orders of the criminal.

Ken Fagerman, RPh, a long-time pharmacist and now author of this important book, began his experience and passion to prevent drug diversion and safeguard pharmacy employees when working in the South Bend, Indiana community. Pharmacy Crime Watch (PCW) was formed as a collaboration between local pharmacists and the police. This unique local program resulted in scores of arrests as pharmacy robberies were becoming more violent in this area and across the nation.

Ken goes on to say in the book that forming a partnership with law enforcement, like the PCW, can become a learning experience as to what police need to successfully pursue criminal offenses such as forged and altered prescriptions, doctor shopping, and armed robberies. He talks about something that law enforcement deals with every day—probable cause. Knowing what that means specifically, and the fact that it is something law enforcement needs in order to proceed, is very important for pharmacists to understand.

What is equally important is Ken’s mention that collaboration is also an opportunity for the pharmacist to teach the local police about pharmaceutical diversion. Even though this problem is huge in every agency, and it has been given incredible press, many law enforcement officers remain clueless—or something very close to that—on criminal offenses that surround prescription drugs.

The reason for this usually starts at or near the very top of the police hierarchy. In some instances, they choose not to recognize this type of crime or indicate that there is no money in the budget to assign even a single police officer to deal with this type of drug crime, while entire teams are utilized toward the enforcement of laws against illicit drug possession and trafficking.

On the other side, some police programs that focus on pursuing diverters have come from a passion developed by the officer on the street. When he or she has a chance to investigate a pharmacy crime, the officer realizes how important that job is and how much it is needed in their community. They are ultimately able to convince the upper echelon of their department of the need to commit more resources to this problem.

Staring Down the Barrel covers a wide array of pharmacy crimes and discusses what the pharmacy employee needs to do during a robbery situation: comply, try to stay calm, and take note of as many things around you as you can that will ultimately help the police, despite the stress of being an actual victim.

Ken also goes over 40 pharmacy crime cases in the book, which are taken from real-world PCW experiences. He dissects them as to what happened and provides suggested actions that were taken or could have been taken in the incident.

The formation of your own PCW is also addressed in the book, and it is something for you to consider setting up in your own community. Although not every pharmacy initially participated in the PCW, within a couple of months and with persistence at the monthly pharmacy meetings, the reports and cooperation with law enforcement began to pay dividends. The use of the media for this program is also a huge plus, as the public becomes more aware of these types of crimes and what is being done to prevent them.

Once again, the law enforcement component is essential, not only to respond to and arrest the perpetrators but also for following up with the pharmacy employees to let them know the outcome of investigations, arrests, and ultimate court findings and sentences imposed. This bond is crucial in keeping the program working and for its ultimate success.

I would urge any of you, especially those of you who are in the retail pharmacy business, to pick up a copy of Ken Fagerman’s book (available on Amazon.com). His common sense and insight into this nationwide problem, which could impact your personal safety, is an important read for any pharmacy employee.


Cmdr Burke is a 40-year veteran of law enforcement and the current president of the National Association of Drug Diversion Investigators. He can be reached by e-mail at burke@naddi.org, via the website www.rxdiversion.com, or by telephone at 513-336-0070.