Supervisory Special Agent Terry E. Davis
DEA Tactical Diversion Squad
New Orleans Field Division
Prescription drug abuse has always been around. It is
estimated that more than 4 billion prescriptions are written
annually in the US. Approximately 40% of them go unused
(outside of a hospital setting)
Is the Nation’s fastest growing drug problem and has been
classified as an epidemic.
In 2008, 36,540 unintentional drug overdose deaths
occurred in the United States. Opioid pain relievers were
involved in 14,800 deaths (73.8%) of the 20,044
prescription drug overdose deaths. According to the CDC,
one person dies from prescription drug abuse every 19
minutes1.
Opioid pain relievers were involved in more overdose
deaths than cocaine and heroin combined1.
1SOURCE:
CDC “Morbidity and Mortality Weekly Report.” January 2012 and 2010 Press Release regarding SRDDA
2
America has 4% of the
world’s population, but uses
40% of the pharmaceuticals
produced
Drug Overdose Mortality Rates per 100,000 People
1999
Source: Trust for America’s Health,
www.healthyamericans.org. “Prescription Drug
Abuse: Strategies to Stop the Epidemic (2013)”
U.S. Drug Enforcement
Drug Overdose Mortality Rates per 100,000 People
2010
Source: Trust for America’s Health,
www.healthyamericans.org. “Prescription Drug
Abuse: Strategies to Stop the Epidemic (2013)”
U.S. Drug Enforcement
Elvis Presley
August 16, 1977
Gerald Levert
November 10, 2006
Anna Nicole
Smith
February 8, 2007
Marilyn Monroe
August 5, 1962
Michael Jackson
June 25, 2009
Heath Ledger
January 22, 2008
Luna Vachon
August 27, 2010
Michael Baze
May 10, 2011
Whitney Houston
February 11, 2012
Thomas Kinkade
April 6, 2012
6
Narcotics – Codeine, Fentanyl, Hydrocodone,
Oxycontin, Methadone
Stimulants – Adderall, Ritalin
Depressants – Valium, Xanax, Klonopin, GHB,
Ketamine
Hallucinogens
Anabolic Steroids
Hydrocodone (Schedule III)
Oxycodone/OxyContin® (Schedule II)
Oxymorphone/Opana® (Schedule II)
Hydromorphone/Dilaudid (Schedule II)
Xanax®/Alprazolam (Schedule IV)
Methadone (Schedule II)
Fentanyl (Schedule II)
Adderall® (Schedule II)
Cough Syrup (Schedule V)
Carisoprodol/Soma® (Schedule IV)
9
Created to Prevent, Detect, and Investigate the
Illegal Diversion of Pharmaceutical Controlled
Substances and Listed Chemicals from
Legitimate Channels to the Black Market.
While Ensuring an Adequate and Uninterrupted
Supply of Controlled Substances to Meet
Legitimate Medical, Commercial, and Scientific
Needs.
10
DEA has historically utilized Tactical Diversion Squads
(TDS) since the late 1970’s.
TDS Program was established in FY 1996. There are
currently 66 Tactical Diversion Squads throughout the
US.
TDS combine DEA resources with those of federal, state
and local law enforcement agencies in an innovative
effort to investigate, disrupt and dismantle those
suspected of violating the CSA or other federal, state or
local statutes pertaining to the diversion of licit
pharmaceuticals and/or chemicals.
11
Atlanta
Atlanta/Nashville
Boston
Boston/Worcester
Chicago
Dallas
Denver
Denver/Billings
Denver/Salt Lake City
Detroit
Detroit/Cleveland
Detroit/Columbus
Detroit/Lexington
El Paso
El Paso/Albuquerque
Houston
Houston/Austin
Houston/Beaumont
Los Angeles
Los Angeles/Honolulu
Los Angeles/Las Vegas
Miami
Miami/Orlando
Miami/Tampa
Newark
New Orleans
New Orleans/Baton Rouge
New Orleans/ Jackson
New Orleans/Little Rock
New York
New York/Albany
New York/Long Island
Philadelphia
Philadelphia/Pittsburgh
Phoenix
Phoenix/Tucson
San Diego
San Francisco/Oakland
San Francisco/Sacramento
San Juan
San Juan/Ponce
Seattle
Seattle/Portland
St. Louis
St. Louis/Kansas City
Washington
Washington/Baltimore
Washington/Charleston*
12
WA
MT
ME
ND
OR
ID
NV
CA
WY
AZ
CO
MI
IA
IL
KS
OK
NM
TX
MO
AR
LA
H
NY
WI
SD
NE
UT
V N
T
MN
MS
PA
IN OH W
V VA
KY
NC
TN
SC
AL GA
N
J
RI
DE
MD
DC
PR
FL
AK
HI
U.S. Average per 100K = 2,649,444 dosage units
Above Average = 3,311,805 dosage units or more
Average = 2,649,444 dosage units
* 100KPopulation based on2010 Census
Below Average = 1,987,083 dosage units or less
13
Source: Drug Enforcement Administration, Office of Diversion Control, Pharmaceutical Investigations Section, Targeting and Analysis Unit
Most current ARCOS information as of 03/11/13
RANK STATE TOTAL
(Per 100K)
1
2
3
4
5
6
7
8
9
10
11
TN
NV
AL
KY
OK
WV
IN
MI
MS
AR
LA
7,767,944
5,443,322
5,372,927
5,284,600
5,082,838
4,883,258
4,508,288
4,333,021
4,284,556
4,218,142
3,764,813
RANK STATE TOTAL
(Per 100K)
12
13
14
15
16
17
18
19
20
21
22
SC
MO
KS
ID
TX
OR
MT
GA
CA
OH
IL
3,466,685
3,440,540
3,369,731
3,369,615
3,276,228
3,099,499
2,779,656
2,729,464
2,707,841
2,585,334
2,442,088
RANK STATE TOTAL
(Per 100K)
23
24
25
26
27
28
29
30
31
32
33
IA
WY
NC
UT
AZ
WA
ME
NM
NE
RI
WI
2,364,739
2,355,963
2,351,184
2,278,450
2,270,759
2,253,801
2,245,767
2,186,198
2,087,345
2,002,672
1,981,589
RANK STATE TOTAL
(Per 100K)
34
35
36
37
38
39
40
41
42
43
44
SD
FL
PA
VA
AK
ND
CO
HI
MN
NY
VT
RANK STATE TOTAL
1,973,366
1,917,723
1,871,809
1,869,073
1,679,852
1,630,154
1,609,922
1,425,983
1,357,526
1,290,354
1,208,273
(Per 100K)
45
46
47
48
49
50
51
52
53
54
NH 1,152,990
DE 1,054,586
CT 983,049
MA 924,324
MD 897,916
NJ 674,921
VI 404,216
DC 400,490
GU 138,093
PR
52,393
14
Source: Drug Enforcement Administration, Office of Diversion Control, Pharmaceutical Investigations Section, Targeting and Analysis Unit
Most current ARCOS information as of 03/11/13
Steven Tyler
Rush Limbaugh
Eminem
Brett Farve
Jack T. Camp, Jr.
October 10, 2010
November 18, 2010
March 10, 2011
15
16
Illicit Drugs1
22.6 (8.9%)
Marijuana
17.4 (6.9%)
Psychotherapeutics
7.0 (2.7%)
Cocaine
1.5 (0.6%)
Hallucinogens
1.2 (0.5%)
Inhalants
0.7 (0.3%)
Heroin
0.2 (0.1%)
0
5
10
15
20
25
Numbers in Millions
1
Illicit Drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type
psychotherapeutics used non-medically.
SOURCE: 2010 National Survey on Drug Use and Health (NSDUH) published September 2011 by the Dept of HHS/ Substance
Abuse and Mental Health Services Administration (SAMHSA)
17
SOURCE: 2010 National Survey on Drug Use and Health (NSDUH) published September 2011 by the Dept of HHS/ Substance
Abuse and Mental Health Services Administration (SAMHSA)
19
20
Administrative
Immediate Suspension Order (ISO)
Memorandum of Agreement (MOA)
Order to Show Cause (OTSC)
Civil
Fines
Criminal
Arrests
Forfeitures
21
High school students were asked questions about prescription
drugs.
Overall, 20.7 % of students admitted taking prescription drugs
that were not prescribed to them one or more times during
their life. No significant increase from 2009 (20.2%) to 2011.
These drugs included:
Adderall®
Codeine
OxyContin®
Percocet®
Ritalin®
Vicodin®
Xanax®
SOURCE: Center for Disease Control (CDC), 2011 Youth Risk Behavior Surveillance, published June 08, 2012
22
Every day 2,500 teens use prescription drugs to get high for
the first time.
Many teens mistakenly believe that pharmaceuticals are
safer than “street drugs” for a variety of reasons:
These are medicines
They can be obtained from doctors, pharmacies,
friends or family members
It is not necessary to buy them from traditional “drug
dealers”
Information on effects of these drugs are widely
available
1SOURCE:
2010 Parents and Teens Attitude Tracking Study Report, Partnership for a Drug-Free America and MetLife
Foundation, published April 6, 2011
23
In 2009-2010, teens who used pain relievers
non-medically in the past year perception on
the availability of prescription drugs1:
38% believed prescription drugs are everywhere
47% believe it’s easy to get than illegal drugs
51% from their own family’s medicine cabinets
49% from their friends
1SOURCE:
2010 Parents and Teens Attitude Tracking Study Report, Partnership for a Drug-Free America and MetLife
Foundation, published April 6, 2011
24
FY-2012 (May 16, 2012) 111 Cases
Total Assets Seized: $8,996,979
Assets Seized Value: $7,907,158 + FIRE: $1,089,821
FY-2011
173 Cases
Total Assets Seized: $54,450,882
Assets Seized Value: $46,456,330 + FIRE: $7,994,552
FY-2010
90 Cases
Total Assets Seized: $44,464,051
Assets Seized Value: $15,318,160 + FIRE: $29,145,891
**Since FY-2008: 449 cases, $139,129,770**
Target Specific
Certain type of drugs
Pharmacy and delivery vehicles
Burglary/Robbery (Armed or Unarmed)
Individuals or Organizations
27
CALIFORNIA
COUNTIES
U.S. (Nationwide) – 688
State of California – 39
Source: DEA Drug Theft & Loss Database as of April 20, 2012
SAN DIEGO
ALAMEDA
CONTRA COSTA
LOS ANGELES
SAN JOAQUIN
STANISLAUS
COLUSA
MENDOCINO
MONTEREY
ORANGE
RIVERSIDE
SAN BERNARDINO
SHASTA
SOLANO
TULARE
VENTURA
YOLO
# OF
PHARM
THEFTS
10
4
4
3
3
3
2
1
1
1
1
1
1
1
1
1
1
28
Rank State Total Rank State Total Rank State Total Rank State Total Rank State Total
1
2
3
4
5
6
7
8
9
10
11
IN
AZ
FL
TN
CA
CO
PA
NY
KY
MI
NC
53
50
49
43
39
38
36
29
27
24
23
12
13
14
15
16
17
18
19
20
21
22
MD
WA
OK
ME
NV
OH
OR
NJ
SC
VA
AL
22
21
18
17
17
16
15
14
14
13
12
Source: DEA Drug Theft & Loss Database as of May 30, 2012
23
24
25
26
27
28
29
30
31
32
33
MA
TX
IL
MS
MN
MO
NH
WI
AR
GA
LA
12
11
8
8
7
7
7
6
5
5
4
34
35
36
37
38
39
40
41
42
43
44
UT
DE
MT
WV
CT
IA
ID
KS
NE
NM
RI
4
3
2
2
1
1
1
1
1
1
1
45
46
47
48
49
50
SD
WY
AK
HI
ND
VT
1
1
0
0
0
0
29
U.S. (Nationwide) – 202
State of California – 6
Source: DEA Drug Theft & Loss Database as of April 20, 2012
CALIFORNIA
COUNTIES
LOS ANGELES
ORANGE
SAN DIEGO
SOLANO
# OF
PHARM
THEFTS
3
1
1
1
30
Rank State Total
1
2
3
4
5
6
7
8
9
10
11
IN
AZ
OH
ME
MD
PA
CO
CA
TX
KY
MN
32
23
21
14
13
13
12
10
9
9
9
Rank State Total
12
13
14
15
16
17
18
19
20
21
22
WI
TN
NC
NY
FL
IL
VA
MI
MA
AL
NJ
8
8
8
8
7
6
5
5
5
5
5
Source: DEA Drug Theft & Loss Database as of May 30, 2012
Rank State Total
23
24
25
26
27
28
29
30
31
32
33
OK
NH
SC
LA
AR
OR
NE
WA
NV
CT
DE
5
4
4
4
3
3
2
1
1
1
1
Rank State Total
34
35
36
37
38
39
40
41
42
43
44
WV
UT
KS
AK
GA
HI
IA
ID
MO
MS
MT
1
1
1
0
0
0
0
0
0
0
0
Rank State Total
45
46
47
48
49
50
ND
NM
RI
SD
VT
WY
0
0
0
0
0
0
31
St. George, Utah is known as a good place to raise a
family or to retire, but aside from the wholesome
image, it's fighting a newfound heroin problem.
Police point to users like Karli Chambers:
27 year-old mother of two had been addicted to
prescription drugs, then made an economic decision.
"I couldn't afford the pills," Chambers said in an
interview at the Southwest Behavioral Health Center
in St. George, where she is getting counseling. "It was
too much. The only thing I could find was heroin."
1SOURCE:
Rick Egan, Salt Lake Tribune, October 8, 2010
33
OTC
Friends and Family
Doctor Shopping
Forgery
Theft
Internet
Street/stranger drug transactions
Crossover to Heroin (cost/accessibility/feeling)
K2 Spice
Bath Salts
Molly
To address this issue, National Framework (Four-Prong
Approach):
Education
Enforcement
Monitoring
Proper Medication Disposal
SOURCE: ONDCP’s 2011 Prescription Drug Abuse Prevention Plan released on Tuesday, April 19, 2011
36
April 26, 2014
10:00 AM – 2:00 PM
5,659 Locations throughout the United States including
locations throughout the Greater New Orleans area
4,268 Participating Law Enforcement Agencies
The previous 6 national events have prevented a total of
approx. 2 million pounds of unwanted/unused
prescription drugs from falling into the wrong hands
Contact Local DEA Office
Ask for TDS Group or Diversion Group
877 RxAbuse Hotline
The Rx Abuse Hotline is a toll free number that the public
can use to report what they believe may be illegal activity
concerning controlled pharmaceuticals.
October 01, 2011- March 02, 2012: 215 calls
UMPIRE
UMPIRE (Unlawful Medical Products Internet Reporting
Effort) is a Diversion Internet web-based system that was
established in 2002. The UMPIRE system provides the public
with an avenue to report what they believe may be illegal
activity concerning controlled pharmaceuticals.
October 01, 2011-March 02, 2012: 123 submissions
38
39
Cases Against Doctors
DEA maintains a list on the Diversion website of all doctors
(MD and DO) who were federally convicted for the diversion of
controlled pharmaceuticals since January 2003.
The intent is to convey to the public and our registrant
population that DEA does not target physicians who legitimately
and properly treat pain and that the doctors who are listed were
arrested for truly egregious behavior.
Entries are normally published following sentencing.
High-profile cases are sometimes published immediately
following conviction. March 02, 2012: 240 cases have been
posted.
Website address: www.deadiversion.usdoj.gov
40
41
42
Extortion Scam
Ongoing international phone scam
Based in Dominican Republic
Contact individuals who have ordered on-line meds
Represent that they are DEA agents
Demand payment in lieu of arrest
Payment sent to DR via Western Union/Money Gram
Hotline available on internet
DEA contacting callers and documenting all calls
11 indicted in January 2011, pending extradition process
October 01, 2011-March 02, 2012: 1,507 calls received
Attempted: $977,825.00 Paid to date: $142,145.00
Website address: www.dea.gov or www.deadiversion.usdoj.gov
43
44
Supervisory Special Agent Terry Davis
Tactical Diversion Squad
New Orleans Field Division
[email protected]
504-840-1070
504-575-5849