Rx Abuse in Rural America
Cmdr John Burke
John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 40-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at burke@choice. net, via the Web site www.rxdiversion. com, or by phone at 513-336-0070.
I recently had the opportunity to sit down with Sheriff Kim Rogers of the Adams County Sheriff's Office from rural southern Ohio. Sheriff Rogers has a big prescription drug problem in his county that is killing his residents, and he wants to do something about it. Adams County is a beautiful area of the Buckeye State, with only 27,000 residents; it also is one of the most rural counties in Ohio, about 70 miles east of Cincinnati. Adams County has had 16 overdose deaths attributed to prescription drugs since January 1, 2009. In addition, over 60 additional overdose incidents have occurred that fortunately did not result in death. As Sheriff Rogers said, "We thought it was an alarming number." I would certainly agree. In the spring of 2009, a collaborative task force of law enforcement, physicians, and pharmacists began to meet in the county to try and find answers to this high level of overdose deaths related to pharmaceuticals. A visit from the executive director of the Ohio Board of Pharmacy, who was armed with statistics for the group, only fueled their passion to do something about the problem. Sheriff Rogers indicated that the cooperative effort has been outstanding, but he needs help from the state legislature and his own association. The Buckeye State Sheriff's Association (BSSA) is a powerful group made up of all of Ohio's 88 county sheriffs, who Rogers hopes can be a good conduit in getting legislation passed dealing with the problem of abused pain medication. In response, the BSSA formed a committee to deal with the problem, which I was honored to be asked to join.
Rural law enforcement faces some of the same problems as urban officers, but usually with far fewer resources. Sheriff Rogers recognizes one problem- Ohio's physicians are not utilizing our premiere prescription monitoring program, Ohio Automated Rx Reporting System (OARRS). He is proposing that Ohio pass legislation requiring physicians to run an OARRS report on every patient who receives a controlled substance prescription. Rogers feels that this will uncover "doctor shopping" and other deceptions by drug-seekers and help to reduce the problem. OARRS is a free, completely Internet-based system, with a response time of about 15 seconds from the Ohio State Board of Pharmacy prescription monitoring program. Sheriff Rogers' other concern is the massive abuse and misuse of the Medicaid system. Adams County is one of the poorest counties in Ohio, with a considerable percentage of the residents on Medicaid. This public insurance entity has always been a vehicle for prescription drug offenders to use to obtain their medication for addictions, resale, or both. Rogers wants Ohio legislators to require Medicaid to issue a different colored card for those who have been convicted of scamming the system. This would allow physicians and pharmacists to readily identify a patient who has been involved in illegal activity and to be alert for potential problems. His contention is that, just as we identify the residences of our sex offenders and provide special license plates for our impaired drivers, we should identify prescription drug offenders using our state Medicaid programs. I certainly applaud Sheriff Rogers and the BSSA for trying to do something in Ohio about the prescription drug problem. His problem is not unlike many rural areas of our country that are seeing the same issue of pharmaceutical diversion. Rural law enforcement faces some of the same problems as urban officers, but usually with far fewer resources. Therefore, they require even more assistance from state law enforcement in order to deal with these kinds of issues. With the reality of lowered state law enforcement budgets and looming layoffs, however, help from this source does not appear to be forthcoming. Representing the National Association of Drug Diversion Investigators, I will make sure we do all we can to try and ease the problem in Adams County. A positive result in this southern Ohio community may mean help for rural law enforcement everywhere.
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