Indictments announced this week against medical professionals accused of diverting codeine and other medicines to street sales are the opening thrust in an effort to cripple an illegal prescription drug trade that may exceed $1 billion a year in California, authorities said Friday.
The crackdown "is the first time that there has been a coordinated effort by all involved authorities to delve into the problem and stop it," Joyce A. Karlin, assistant U.S. attorney in Los Angeles, said in an interview. "I think it's going to make a tremendous difference, because it won't be a one-time attack. We're going to keep going until we're done."
Seventeen people--including seven doctors and two pharmacists, as well as medical clinic operators and their assistants--were indicted Thursday on federal charges of illegally prescribing and dispensing drugs. State authorities simultaneously announced civil actions against 31 defendants, including 13 of those charged with federal crimes.
5 Still Being Sought
Arrests in the cases continued Friday. By late Friday afternoon, 12 of the accused had been arrested and five suspects were still being sought.
William G. Plested III, president of the Los Angeles County Medical Assn., said the organization applauds efforts to prevent illegal prescription of drugs.
"I'm sorry it happens," Plested said. "I'm embarrassed for my profession. But I'm more than willing to do anything I can to help stamp out the problem. I personally think it's awful. We are extremely cooperative with any of the authorities in any of these cases."
The medical association has few powers, however, that would enable it to enforce laws against improper dispensing of drugs, Plested said.
"This is really criminal activity, and it falls outside the usual arena of peer review," he said.
The state Board of Medical Quality Assurance and the Board of Pharmacy, which participated in the joint federal-state investigation, are the medical authorities equipped to help monitor compliance with prescription drug laws, Plested said.
State Atty. Gen. John K. Van de Kamp said Thursday, in announcing the task force action, that Los Angeles is "the state--and quite possibly the national--capital for prescription-drug abuse."
Statistics released by the attorney general's office, based on data from the U.S. Drug Enforcement Administration, show that in 1983--the last full year for which information is available--California was third in the nation in per capita consumption of codeine-based drugs; second for pentobarbital , a depressant; third for Preludin, a stimulant, and fourth for Dilaudid, a habit-forming painkiller.
High levels of codeine distribution show up statewide, but "distribution of Ritalin (a stimulant), Dilaudid and other substances is significantly higher in southern California, particularly in Los Angeles," the attorney general's report said. "The distribution of Preludin is almost entirely centered in Los Angeles."
Based on population and the national mean distribution of the drug, the 900 ZIP code area of Los Angeles, with slightly more than 2 million people, could have been expected to receive the equivalent of 80,000 units of Preludin in 1983 and actually received the equivalent of 1,160,000 units, the report said.
Another major Los Angeles problem, the report said, is "loads," or codeine combined with Doriden, a depressant. The mixture, sometimes used as a heroin substitute, was responsible for more than 40 deaths in Los Angeles County during 1983, the report said.
The total street value of prescription drugs diverted to abuse in California "may well exceed $1 billion per year," the report said.
The doctors charged this week allegedly operated out of about 50 Los Angeles-area clinics, writing prescriptions for phony medical problems to enable "runners"--people paid to make the transactions--to purchase the drugs and resell them to street dealers, Karlin said.
Bail ranging from $5,000 to $100,000 has been set for most defendants in the federal cases, and at least 10 of the accused were free by late Friday, Karlin said. One defendant, John Berrel Barnes Jr., 31, a Los Angeles physician, remained in custody with no bail set because "he is viewed as a flight risk," Karlin said. A detention hearing for Barnes will be held next week.