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Monday, November 22, 2004

When the war on drugs meets your local pharmacy



SUMMIT COUNTY — You hear about the meth labs. You hear about the drug task force busting up a marijuana-growing operation.

But what you rarely hear about, the new problem plaguing law enforcement, comes from the medical community.

It’s called doctor shopping. Why go to all the trouble of finding a drug dealer, when a pharmacist can get you high?

Here’s the way it works: A person has oral surgery or a back injury, and the doctor prescribes a painkiller. Or maybe it was a friend, innocently passing on a pill to a friend. They take one, two, run through the bottle and then, possibly, want more.

Many analgesics are addictive. They work on the nervous system, building up tolerance and dependence, just like their chemical cousins obtained on the streets. The opiates in pills work just like the opiates in heroin.

So, if an addict is going to get more, a doctor is his or her only hope.

“If taken properly for pain, that’s fine,” said Roy Hoff, pharmacy manager at City Market’s Breckenridge store. “But they can be abused. Unfortunately, some of them are seen as party drugs up here. We do see it a lot.”

Hoff said he suspects Summit countians’ active lifestyles contribute to the problem. Doctors issue a lot of prescriptions for painkillers for all the biking and skiing injuries.

How does a pharmacist tell the difference between a doctor-shopper and a legitimate prescription?

It’s not easy. First of all, pharmacists don’t have a common computer database. Hoff usually can’t tell if another pharmacist has already refused to fill a prescription or if the customer tried to use a forged doctor’s note somewhere else.

The doctor-shoppers get tricky, Hoff said. In one case, investigators learned a customer had been to Vail and Grand Junction trying to score before being apprehended in Summit County.

But there are tip-offs. If people give insurance information in an effort to reduce out-of-pocket costs, they’re almost always caught.

Sometimes the customer asks for a brand-name drug and wants to pay in cash.

“That usually means they’re going to sell them,” Hoff said. “Otherwise, they’d take the generic equivalent, because it’s cheaper.”

Pharmacists can be overly suspicious, though, says Sondra Douglas of Keystone’s Mountain View Drug.

Douglas said she has heard of customers being denied a prescription because of doubts or fears, only to learn later the prescription was valid.

Douglas said she herself turned someone away, only to learn later the patient truly needed the medication after surviving a car accident and head injury.

“I’m 62,” she said. “We didn’t have this problem in my generation. Now you can take classes to learn how to recognize the problem.”

Douglas said the key for pharmacists is communicating with patients and their doctors, something that doesn’t happen as often when lines at the counter get long or pharmacists get busy.

The one thing both pharmacists agreed on: Summit County’s drug task force is helping address the problem. Douglas and Hoff have referred cases to the task force and occasionally field questions from agents.

“They’re doing a good job,” Douglas said.

In the end, though, it’s a health problem, Hoff said. He lamented that by the time a doctor-shopper is discovered, the problem is well along its course. Law enforcement has to be involved, he said, but it will take doctors to help the patient.

“I don’t know how you stop it,” he said. “Many times, you’re dealing with young people who feel invulnerable to everything. Before you know it, they have problem they physically can’t deal with.”

This is the final in a three-part series on Summit County’s chemical culture.



Reid Williams can be reached at (970) 668-3998, ext. 237, or at rwilliams@summitdaily.com.


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