Although there are numerous prescription drug scams and deceptions, a portion of the illegal pharmaceutical trade is conducted by direct sales from seller to buyer. No one really knows what percentage of drug diversion is accomplished in this manner, but there is no doubt that trafficking in prescription drugs is on the rise.
Drugs that are sold illegally come from a variety of sources. One source is doctor shoppers who visit multiple practitioners every month to obtain their drugs. They may also be addicted, and so in addition to selling part of their substances they must feed their own habit. This money may be needed to pay for physician's visits, or for the pharmaceuticals themselves, if health insurance is unavailable or cannot be used.
In some cases, terminally ill patients are known to be the source of high-powered and high-priced opiates available on the street. These people are typically not in as much pain as they have indicated to their physician and have been over-prescribed in an attempt to make them comfortable.
One such terminal patient in our jurisdiction was receiving 100 tablets of 4-mg Dilaudid (hydromorphone) each week. He was selling all of them and relying on his fentanyl patches and codeine to relieve his pain. Because he was able to sell the tablets for $60 a piece, he was turning a $6000-a-week profit in sales. A tip to the physician should have been that the patient was insisting on the brand name drug, even though it cost him more than $100 per week over the generic.
Drugs stolen from wholesale and retail pharmacies, and pharmaceutical packages intended for these outlets, often make their way to the street traffickers. These thefts can account for large numbers of drugs because usually entire bottles of controlled substances are stolen.
Pharmacy robberies and burglaries also are excellent sources of pharmaceuticals for the street seller. These felonies can yield huge numbers of prescriptions, given that these crimes typically involve significant amounts of drugs taken in the offenses.
Another typical resource in many urban communities is for a street seller to have dozens of patients who receive controlled substances every month, usually obtaining them from Medicaid, veterans' hospitals, or other government insurance programs. These drugs are obtained free and then are sold to the street trafficker for a fraction of the true illicit value. The patients are often elderly, on fixed incomes, and they gladly sell their pills to these prescription drug traffickers. Because street values can range from $1 to $3 per pill for the most abused benzodiazepines, to $60 to $80 a pill for the most popular opiates, it is no wonder that this is a lucrative market.
We recently arrested a large trafficker who was in possession of 22,000 alprazolam tablets. These drugs were sold by the pharmaceutical company to be marketed only in Australia, but they found their way to southwest Ohio. It seems that they were smuggled through Mexico, into Arizona, and shipped by motor vehicle to Ohio. The trafficker had paid less than $1 per pill and had a consistent market where he could obtain $3 per pill. This resulted in a $40,000+ profit that he was able to turn over every month.
Supply and demand determine price on most of our legal commodities in the United States. This same principle, however, applies to the illegal trafficking in prescription drugs. As prescription drug abuse becomes more popular, street prices are sure to rise, providing even bigger profits for those in this illicit trade.