LIHU‘E — Prescription pill abuse is outpacing illicit drugs as both a health epidemic and corresponding addiction-related crimes, according to officials. Lawmakers are now tweaking a legal system that was not designed to enforce abuse of the medicine cabinet. Editor’s
LIHU‘E — Prescription pill abuse is outpacing illicit drugs as
both a health epidemic and corresponding addiction-related crimes,
according to officials. Lawmakers are now tweaking a legal system
that was not designed to enforce abuse of the medicine cabinet.
Editor’s note: This is the second of a multi-part series on prescription drugs. The focus of the next part, to be published in Tuesday’s edition of The Garden Island, will be on the resources and treatment centers residents can turn to for help.
LIHU‘E — Prescription pill abuse is outpacing illicit drugs as both a health epidemic and corresponding addiction-related crimes, according to officials. Lawmakers are now tweaking a legal system that was not designed to enforce abuse of the medicine cabinet.
Government officials, law enforcement and the courts are working on legal and policy strategies to respond to 513 Class C felony criminal pharmaceutical drug cases in Hawai‘i last year — nearly half of all 1,066 drug-related cases, according to State Deputy Director of Public Safety Keith Kamita.
Some 250 crimes involved forged prescriptions, and Kamita said this is encouraged by legal loopholes that allow “dial-a-doc” physicians to prescribe more liberally.
The “Spear bill” — named for Harold Spear III, a physician arrested in Kaua‘i and Alabama for dispensing drugs without his presence in consultation — would tighten loopholes on prescription laws.
“This makes into law the things we take as common sense, such as having to physically examine a patient,” Kamita said.
County Prosecutor Shaylene Iseri-Carvalho said the Prosecuting Attorney Association, the State Attorney General and other county prosecutors are helping to shape that legislation.
They are also working to reestablish electronic tracking of narcotic prescriptions to alert law enforcement when people try filling them through several physicians.
The database maintenance positions were eliminated two years ago because of funding, she said.
Prescription drug abuse presents challenges on several fronts, Iseri-Carvalho said. It’s about ensuring doctors and patients are responsible with managing prescriptions, but also about keeping kids out of the medicine cabinets while tailoring laws to deal with burglaries and ancillary crimes associated with prescription drugs.
“The problem that we see between prescription and cocaine or crystal meth is that the public legitimizes drugs when the doctor gives a prescription, even when it is abused,” Iseri-Carvalho said.
“There is a sense of empathy and that is not the mentality directed toward people who use crystal meth and cocaine.”
Some defendants avoid jail time through Drug Court and similar programs for eligible non-violent offenders. They receive addiction treatment as they make restitution through public service and probation with drug testing.
Drug Court depends on funding for youth and adult off-Island residential treatment, on-Island out-patient care and recovery programs, substance abuse counseling certification, and related outreach and prevention programs.
Legal system adapting
The legal system is just beginning to adjust to prosecute the non-intended use of prescription narcotics, according to First Deputy Prosecutor Jake Delaplane. He said pills are a nebulous challenge in a system designed for methamphetamine or cocaine trafficking and distribution.
The challenge is to identify users who buy drugs to use and then sell the rest to maintain their habit.
Others do not maintain their drug lifestyle so controllably, and commit other types of crimes to maintain their addiction, including stealing from medicine cabinets, identity theft, robbery, assault and homicide.
“There have been more than 50 prescription drug-related felony cases indicted so far this year,” Delaplane said in an interview last month.
“The number of misdemeanor and non-drug offenses charged have a significant tie to prescription drug abuse.”
Another problem is the legality of making an arrest when someone is using a valid prescription but not consistent with the doctor’s advice, he said.
It is legal to be in possession of prescribed oxycodone tablets but the addict may be smoking it or making it into a solution to administer anally.
Police have special training now to detect “drugged driving” when pharmaceuticals cannot be detected by smell or other road tests.
Prescription drug addiction is often more potent than their illicit drug counterpart, Kamita said. This makes the addict more dangerous in their pursuit of maintaining the high, he added.
Kapa‘a resident Aureo Moore, whose prescription pill addiction has been discussed by family members, was murdered Dec. 17, 2010, at Anahola Beach Park.
Officials said the man who was arrested for shooting him, Vicente Hilario, was allegedly a “V-12” addict.
V-12 is a highly addictive mix of 30 mg oxycodone and morphine tablets.
“One of worst things that can happen is to start going through withdrawal,” Kamita said.
“There is the immediate effect and then there is the withdrawal.”
‘Trailmixing’ parties
While alcohol remains the most common and typically the first intoxicating substance used by teens, followed by marijuana, Kamita said prescription medication is surpassing the popularity of illicit drugs.
Despite risk of overdose and death, “trailmixing” or “pharming” drug cocktail parties draw teens and adults.
The allure is not knowing what effect will result from taking a handful of unknown pills from a bowl.
The danger is users don’t know what they are taking, and keep taking them if they don’t have an immediate reaction, Kamita said.
The mix may include fungal antibiotics, nitroglycerin heart medication or an anti-psychotic, he said, and they may not be aware when it is a deadly combination or of the mounting toxicity level in the body.
The “straight kids” often get hooked by thinking prescription pills can’t hurt them, Kamita said.
He advised parents to keep an eye on prescription bottles to see if the contents have been switched with non-prescription medicines of similar look and color.
Kamita said 25 percent of college students report having tried a pharmaceutical drug not prescribed for them. One in 10 teens are using Vicodin, Oxycontin, Ritalin, Adderall, Robitussin, Percodan or Percocet.
Some 47 percent of teens say they get drugs from friends or family or trade for them at school — sometimes just to maintain and avoid going through withdrawals.
“Giving drugs away is a Class C felony,” he said. “You don’t have to have a sale, because you could die.”
Pill dependency among teens rising
Dr. Gerald McKenna, a specialist in treating addiction on Kaua‘i, often testifies in drug cases and reports for the courts. He said there is definitely an increase in the number of teens coming to his clinic with prescription drug dependency problems.
“This happens with the new drug on the block,” McKenna said. “When it is the new in-thing to do, then it is fairly easily available.”
The U.S. Drug Enforcement Administration encourages the community to dispose of unused prescription medications before they are stolen and misused. Pharmacies will dispose of medication and there are special anonymous drop-off events held regularly.
The DEA discourages flushing medications down the toilet or sink because it could have an environmental impact on aquatic life.
See sidebar for the results of a prescription pill take-back event last month on Kaua‘i.
• Tom LaVenture, staff writer, can be reached at 245-3681 (ext. 224) or by emailing tlaventure@ thegardenisland.com.
