Prescription drugs like OxyContin are still leaking out of the medical system's supply chain in Westchester, Rockland and the Hudson Valley, feeding demand by dealers and illicit users, pharmacists, drug counselors and government officials say.
Pharmacist Michael Altman, owner of Greenleaf Pharmacy in Hastings-on-Hudson, said he used to get suspicious requests three or four times a week, with a typical caller asking for 60 oxycodone pills. "The junkies go doctor-shopping, and then they call pharmacists and say, 'I want to pay cash,' " Altman said. By paying cash the drug abusers try to evade monitoring by insurance companies. Money is no object because each pill can fetch $30 to $50 on the street, Altman said.
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The problem is not confined to adults. A survey of Westchester County teenagers in grades 9-12 by Tarrytown-based Student Assistance Services Corp., a not-for-profit substance abuse prevention agency, found an uptick in prescription drug abuse for the fourth quarter of 2011.
"We're seeing more kids using prescription drugs," said executive director Ellen Morehouse. "I'm concerned because we'd seen a decrease in prescription narcotics last year, and now we're seeing it increase again."
In January alone, Westchester County police seized almost 2,000 oxycodone pills in three separate traffic stops on the Hutchinson Parkway. The opiate, sold in a variety of formulations, including brand-name versions OxyContin and Percocet, is known by a variety of street names: oxy, OC and hillbilly heroin.
A study by the federal Drug Abuse Warning Network, or DAWN, covering 2009, the latest year available, found that Rockland County had 11 drug-related suicide deaths. Based on population, that gave Rockland the highest drug-related suicide rate of any reporting downstate New York City suburb. (Westchester County did not provide data.) The rate was four times higher than that in Nassau County on Long Island and twice that of Suffolk County.
Dr. Joan Facelle, Rockland County commissioner of health, noted that "interpretive issues" play a role in categorizing a death as a drug-related suicide, but she acknowledged that Rockland and neighboring counties are facing identical issues.
"We're a microcosm of a larger problem," she said.
The Rockland medical examiner, in his report to DAWN, attributed 15 deaths to narcotic painkillers in 2009, including eight from oxycodone and combinations with that drug. Fifteen deaths were linked to benzodiazepines and anti-anxiety drugs such as Xanax, Valium and Librium.
Putnam had five deaths from benzodiazepines in 2009 and none recorded for oxycodone and combinations.
'There lives ruined'
For Altman, statistics turned to grim reality on Father's Day in 2011, when a gunman in search of painkillers murdered four people in a Long Island pharmacy. After that massacre, the pharmacist decided the human toll was too high. He posted signs in his Hastings-on-Hudson pharmacy's window and on his walls proclaiming, "We are no longer carrying oxycodone."
"This is a crazy drug," Altman said. "It destroys lives. These were people who weren't junkies. They were cops, movie producers who injured themselves and were given oxycodone and their lives were gone. I have close friends whose relatives got on it and their lives were destroyed . . . People go on it not really understanding the risk. I'm talking about highly educated professionals who have their lives ruined."
Just weeks ago, Altman said a customer's son from a Hudson River town came to the pharmacy with a prescription for oxycodone written on a blank stolen in Brooklyn. Altman called the police.
"We might have saved his life," he said of the youth who has a drug habit.
For teenagers, Morehouse said, prescription drugs are attractive because they are perceived as safe, are odorless and hard to detect, can be found in a convenient medicine cabinet and can mask a football injury or enable an all-night cram session before a test.
"There are good kids -- healthy, normal kids -- who are being introduced to substances through pills, and that's a really dangerous trend," Morehouse said.
Laura Bernstein, works at the Atrium Pharmacy in Hawthorne, a stone's throw from Westchester Medical Center in Valhalla.
Atrium sits in a medical office building, insulated from foot traffic and some of the problems facing the drugstore chains, she said. Nevertheless, the pharmacist is unnerved by the thirst for illicit drugs.
One common ploy is to steal blank prescription forms from a doctor's office, Bernstein said.
"Think when you're in a doctor's office," Bernstein said. "A doctor leaves a prescription pad. It's easy to steal a blank. They're valuable."
"Doctor shoppers," who try to get prescriptions from several doctors for the same ailment, also try to game the system.
"We get prescriptions for oxycodone 30 mg from Staten Island," she said. "You're in Westchester and you have to go to a doctor in Staten Island? You're either doctor-shopping or stealing blanks from the office."
At the same time, Bernstein wonders how large a burden should be placed on pharmacists.
"Where does the responsibility lie?" she asked. "Do we have to be policemen? . . . I don't want to be that."
Closing abuse loopholes
There seems to be no one simple solution.
Morehouse and Rockland's Facelle point to outreach and education programs to alert an often-unsuspecting population.
In the wake of the Father's Day massacre and arrests connected to an oxycodone smuggling ring that used the Westchester County Airport, state officials are pushing to tighten prescription distribution.
New York already has a prescription monitoring system, but a lag in reporting creates a window for doctor shopping. In Albany, an I-STOP (Internet System for Tracking Over-Prescribing) bill proposed by state Attorney General Eric Schneiderman and similar bills by others would upgrade the system to let medical professionals see the prescriptions being written for a particular patient in near real time. The Medical Society of the State of New York and several other physician specialty groups, however, have warned that I-STOP would add to their administrative burden and proposed improving the current reporting system instead.
Whichever system is adopted, Altman warns that even effective prescription monitoring may offer no panacea: "It would help, but every time the government puts in a system, people work to find a way around it," Altman said.