A year after David Laffer killed everyone inside Haven Drugs and fled with 10,000 opioid pain pills to feed his wife's habit and his own, the drugs continue to flood the Island in record amounts, according to the most recent data. In more and more instances, they are being linked to overdose deaths, and admissions to treatment programs for opioid abuse are increasing, statistics show.
Law enforcement agents have arrested doctors they blame for supplying the illegal pill market. Lawmakers in Albany passed sweeping legislation to check illegal trade in the drugs, and wary pharmacists have toughened security. But officials acknowledge they face a years-long battle to stem the crisis.
"This problem is not going to go away," said Nassau District Attorney Kathleen Rice, whose office formed a pharmaceutical crimes unit after the Medford shootings. "It is an epidemic and it is getting worse."
In Nassau, there were 92 instances in 2011 in which prescription opioids were linked to overdose deaths, a tally higher than either of the previous two years and more than triple the 2004 figure, according to the county medical examiner's office. Forty-five of those instances came after June 19, the date of the Medford killings.
Suffolk experienced 177 such cases in 2011, the most ever recorded by the county medical examiner's office, compared with 103 in 2004. Eighty of them were logged after the Laffer murders. Data for the first half of 2012 is not yet available. Experts and officials expect no improvement in the near term.
Each year since at least 2004, the earliest year for which data is available, prescription opioids have been linked to more overdose deaths than heroin.
"I think we all have to dig in and be ready for the long haul," said Bridget Brennan, special narcotics prosecutor for the City of New York, whose office helped identify Laffer as the pharmacy shooter. "It's going to be a while before the problem is brought under control."
There is similarly little evidence that the amount of popular prescription opioids being delivered to the region to meet demand has been curbed. Federal Drug Enforcement Administration figures for an area that includes virtually all of Nassau and Suffolk and part of Queens show pharmacies received 1,107,683 grams of oxycodone and hydrocodone in 2011, more than in any of the previous three years and a 47 percent increase over 2008. Fifty percent of the total came from the second half of 2011.
Hydrocodone is the active drug in the brand-name products Vicodin and Lortab. It was the opioid of choice for Laffer and his wife, Melinda Brady. Oxycodone is in such products as OxyContin and Percocet.
In the first quarter of this year, 257,638 grams of the drugs were received, down 5 percent from last year, but still more than in the same periods of 2010, 2009 and 2008.
Admissions to state-certified treatment programs on Long Island for abuse of opioids other than heroin surged 125 percent from 2005 to 2010, going from 1,612 to 3,626, according to the state Office of Alcoholism and Substance Abuse Services.
The office did not have complete figures for 2011, but spokeswoman Jannette Rondo said admissions had "increased significantly from 2010 to 2011." Outpatient treatment cases, for example, spiked by one-third, from about 1,500 to 2,000.
Rondo cautioned that without further study, it was impossible to say whether the rise resulted from increased abuse or better access to treatment.
Despite heightened security, pharmacy robberies remain a threat. Suffolk County police handled 11 such robberies in 2009 and 2010 and 10 last year. Through late May of this year, there were four. Nassau County police did not start tracking pharmacy robberies until after the killings. The department said that since August 2011 through the end of May there were seven pharmacy holdups, all but one closed with an arrest.
That theft on New Year's Eve in Seaford led to a retired Nassau cop mistakenly shooting and killing a Bureau of Alcohol, Tobacco, Firearms and Explosives agent who had intervened. An off-duty NYPD officer shot and killed the robber, who took painkillers and cash.
Growing demand, supply
The startling growth in the production and consumption of prescription opioids in the United States began in the 1990s, spurred largely by drug-industry marketing and a medical community that was persuaded the drugs would help doctors better treat pain
In 2010, pharmacies, hospitals and doctors in the United States were sold four times the amount of the opioid painkillers, than in 1999, according to the federal Centers for Disease Control and Prevention. Medical professionals prescribed enough of the drugs in 2010 to medicate every American adult around-the-clock for a month, the CDC has reported.
Nationally, alarming overdose rates appeared in states such as Kentucky and Florida as much as a decade ago. The impact was being felt on Long Island too, but it was not yet an urgent public issue.
Then Laffer, a recently unemployed shipping clerk, walked into Haven Drugs on that quiet Sunday morning with a .45-caliber pistol and opened fire. He left four people dead on the floor: Raymond Ferguson, 45, a pharmacist who came in on his day off; Jennifer Mejia, 17, a high school senior filling in at the pharmacy for a co-worker; Bryon Sheffield, 71, who was picking up a prescription for his wife's heart ailment and Jaime Taccetta, 33, who was soon to marry.
"The Medford murders took a plague affecting families behind closed doors and thrust it into the public domain," said Jeffrey Reynolds, director of the Long Island Council on Alcoholism and Drug Dependence. "The private hell suddenly became a public hell."
Some Long Island pharmacies simply stopped carrying the prescription opioids that addicts seek. Pharmacists armed themselves and installed bulletproof glass and panic buttons.
Don Cantalino purchased surveillance cameras for his Uniondale Chemists pharmacy, got a pistol permit and now goes to work armed. The entrance is equipped with a device that can spray plant-based DNA on a fleeing robber so authorities can trace a suspect back to the drugstore.
"My employees and their families were wondering whether to even work in a pharmacy," said Cantalino, 53. "There were times when I would be going to work in the morning wondering whether I would come home. So I have taken it very seriously."
Police increased their presence at pharmacies and advised them on security.
"We have frequent patrols of pharmacies," said Suffolk police Chief James Burke. "That is part of a patrolman's daily duties now, much as you would patrol any hazardous area."
Drug Enforcement Administration raids targeted doctors' offices as part of a push to stem the flood of prescription drugs to dealers and addicts. This month, federal prosecutors, joined by their local counterparts, announced charges against 98 suspects, including two Long Island doctors.
One of them, Eric Jacobson, who practiced in Great Neck, had been under scrutiny for supplying Laffer and his wife. Federal authorities have described Jacobson as one of the state's largest distributors of oxycodone. Between August 2010 and December 2011, Jacobson distributed more than 2 million pain pills, court filings state.
In Albany, state lawmakers last week unanimously approved legislation to tightly monitor the legal trade in prescription drugs. The measure -- which calls for real-time tracking of the writing and filling of prescriptions and establishes a range of other stricter controls to dissuade doctor-shoppers -- puts New York at the forefront of efforts by states to curb the epidemic.
"This is easily the most significant step that's been taken" in response to the Laffer killings, said Assemb. Dean Murray (R-East Patchogue), who represents Medford. It could take up to a year to implement the controls and longer still to judge their effectiveness.
A long-term fight
A drop in overdose rates and treatment admissions -- the key indicators the CDC is using to track the epidemic -- will show progress, said Andrew Kolodny, who directs the psychiatry department at Maimonides Medical Center in Brooklyn and is president of Physicians for Responsible Opioid Prescribing.
Nationally -- as on Long Island -- there is no sign of either marker going down.
"They are both shooting up," said Kolodny, who lectures on drug epidemics. "Unfortunately, things are going to get worse before they get better."
Moreover, effects will be felt long after addiction and overdose rates drop. Kolodny said 40 years after the height of the "relatively small" heroin epidemic of the early 1970s that gripped urban areas like New York City, its aftermath is reflected in the damage caused to children forced into the foster care system and infectious diseases such as hepatitis C.
"This epidemic that we are dealing with today is far, far worse and it's affecting just about every single area of the country," he said. "So there is no question that we will all be feeling the effects of this epidemic for the rest of our lives."
With Sarah Crichton and Yancey Roy