Prescriptions supplanting illegal substances as drugs of choice

Health professionals -- both intentionally and unwittingly -- and dishonest patients are diverting powerful and potentially addictive pharmaceuticals from legitimate medical channels, authorities say.

By Tim Reiterman | Los Angeles Times Staff Writer

May 18, 2008

Bob and Carmen Pack play with their two-year-old daughter Noelle, in front of a painting of the couple's deceased children Troy and Alana, April 25, 2008 in Danville, California. They were killed nearly five years ago when a woman, under the influence of prescription drugs and alcohol hit them with her car while they were walking with their mother. (Robert Durell / Los Angeles Times / May 17, 2008)

A Riverside County psychiatrist who drove a Corvette and lived in a gated community allegedly wrote prescriptions in the lobby of his fitness club and outside restaurants for $100 each.

More than $1 million was stashed in luggage at the house of an Orange County physician who sold black plastic bags of narcotic painkillers.

And at one Los Angeles pharmacy, people peddled medications out front while others squeezed inside to buy more drugs.

Health professionals and dishonest patients are diverting powerful and potentially addictive prescription drugs from legitimate medical channels, helping to fuel a shift toward pharmaceuticals as drugs of choice, authorities say.

Pharmacy thefts, robberies and burglaries also are contributing to the problem, investigators say, along with prescription forgeries and Internet pharmacies that require little information before shipping drugs. Nationwide, 25 million doses of commonly abused drugs were reported stolen last year.

In California, where almost 34 million prescriptions for narcotics and other controlled substances were written last year, the drug diversion problem has caught the attention of state Atty. Gen. Jerry Brown. He says he plans to upgrade the state's monitoring system to allow health practitioners to check patients' histories before prescribing potentially dangerous medications.

"Doctors and pharmacies can instantly check out if the patient before them is legitimate or an abuser," Brown said in an interview. "We will be in a better position to control illegal diversion."

Law enforcement officials say high-profile accidental overdoses, such as that of former Playboy Playmate Anna Nicole Smith, are symptomatic of entrenched abuse and misuse of prescription drugs. The federal government's most recent survey reported that 7 million Americans engaged in nonmedical use of pharmaceuticals in 2006 -- up from 6 million two years earlier. And that usage was higher than for any illicit drug except marijuana.

"Unlike illicit drug use, which shows a continuing downward trend, prescription drug abuse . . . has seen a continual rise through the 1990s and has remained stubbornly steady . . . during recent years," Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, told a congressional hearing in March.

And local law enforcement officials cite a surge in the use of prescription drugs as street narcotics.

'Drug of choice'

"What we are seeing is that prescription drugs . . . are quickly becoming the drug of choice and abuse," said Murrieta Police Lt. Dennis Vrooman.

In late 2006 and early 2007, Murrieta police were hearing complaints that psychiatrist Joel Stanley Dreyer -- a cowboy boot-wearing, extreme-fighting aficionado whose personalized license plates read FREUDMD -- was prescribing highly addictive drugs to apparently healthy young people.

Then an Orange County businessman showed up with a sad story that dovetailed with that information. On Christmas Day of 2005, he and his mother had found the body of his 35-year-old sister, Jessica Silva, in her Newport Beach condominium.

Silva seemed an unlikely overdose victim. The divorced saleswoman had about $900,000 in assets. But she had been arrested for drug possession years earlier and gone through rehab -- and the coroner found many drugs in her system. Her last prescription was for OxyContin, a painkiller Dreyer had prescribed a few weeks earlier.

Her brother conducted his own investigation. Posing as a new patient at Dreyer's office, he complained of pain and difficulty sleeping, the brother later told police. Without conducting an examination, Dreyer prescribed three drugs and charged $100, according to an FBI court affidavit.

In 2007, three undercover officers also obtained prescriptions for $100 each during tape-recorded visits, the affidavit says. "And that, my love," Dreyer quipped to a female Drug Enforcement Administration agent, "is the game."

Now Dreyer, whose medical license was suspended last summer, faces a 19-count federal indictment alleging illegal drug dispensing. His attorney, Wayne Gross, declined to comment. Dreyer has pleaded not guilty.

Police say they do not know how much money Dreyer made.

"His car was leased and his home was rented, so that would lead to speculation as to whether he spent all the money or it is hidden somewhere," Murrieta Police Det. John Nelson said.