April and Joe Rovero hold a picture of their son Joey with his birthday cupcakes.… (Liz O. Baylen, Los Angeles…)
Joey Rovero's quest for pills ended at Pacifica Pharmacy.
It was the same for Naythan Kenney,
Matt Stavron and Joseph Gomez.
All four were patients of a Rowland Heights
physician who was a prolific prescriber of narcotic painkillers and other addictive drugs. To get their fix, they needed more than a piece of paper.
They needed a pharmacist willing to dispense the drugs, and at Pacifica they found one.
All four died of drug overdoses after filling prescriptions at the tiny pharmacy in Huntington Beach, court and coroners' records show.
Pacifica's owner, Thang Q. "Frank" Tran, sold pain medications in large quantities. Particularly popular with his customers were high-dose, 80-milligram tablets of OxyContin. Tran filled nearly twice as many of those prescriptions as did nearby Walgreens, CVS and Sav-On pharmacies combined, according to state records.
Many of his customers traveled long distances and paid cash. Rovero drove more than 350 miles from Arizona State University in Tempe to get his prescriptions in Rowland Heights and then 33 more miles to the pharmacy.
"I thought to myself, 'Why in the world would these kids go that much farther out of their way?' " said April Rovero, whose son was 21 when he died. "Someone must have told them to go there."
Pharmacists are supposed to be a last line of defense against misuse of prescription medications. By law, they are required to scrutinize prescriptions, size up customers and refuse to dispense a drug when they suspect the patient has no medical need for it.
Some, however, provide massive amounts of painkillers and anti-anxiety drugs to addicts and dealers with no questions asked, according to state records, regulators and law enforcement officials.
Rogue pharmacists are key enablers of drug abuse and an important source of supply for the illegal market.
State officials who license and oversee pharmacies are overmatched by the scale of the problem.
Prescription drug abuse has increased sharply over the last decade, fueling a doubling of drug fatalities nationwide.
California's 42,000 pharmacists filled 318 million prescriptions last year.
Those for OxyContin, Dilaudid and other potent painkillers have increased 52% over the last five years, according to a review of prescription data collected by the state. The total dosage dispensed by pharmacies has also grown: by nearly 50%, the data show.
The task of identifying careless or corrupt pharmacists and initiating disciplinary action falls to 37 investigators for the California Board of Pharmacy.
"We are struggling to keep up because there are more pharmacies, more licensees, more places to go," said Virginia Herold, the agency's executive director. "We work really hard. But there's a limit to what we can do."
The board has added investigators in recent years. Even so, "we do have some pharmacies that seem to be able to help deliver unconscionable quantities of drugs to patients," Herold said.
It doesn't help that illegal dispensing is a low priority for law enforcement agencies. Criminal prosecutions are rare and penalties typically light.
Rogue pharmacists have a symbiotic relationship with physicians who prescribe drugs for addicts. Neither can flourish without the other.
Their cooperation is usually unplanned. Through trial and error, addicts whose doctor writes prescriptions for narcotics will discover a pharmacist willing to dispense the drugs without the appropriate scrutiny. Then word gets around.
Both pharmacist and doctor can reap a windfall by writing and filling large numbers of prescriptions for cash.
High-volume dispensing of addictive drugs was par for the course at Burbank Medical Pharmacy, according to board records.
In a single day — Dec. 3, 2007 — the pharmacy filled 85 prescriptions for pain medications, according to a board accusation. None of the doctors who wrote the prescriptions were from the Burbank area, nor were any of the patients, the complaint states. Both are signs that a pharmacy is catering to addicts, according to regulators and law enforcement officials.
Burbank Medical also dispensed painkillers in volume to a drug dealer who claimed to be picking them up for patients too sick to do so, according to the board accusation and court files. The dealer was convicted in a prescription drug fraud scheme that prosecutors said generated millions of dollars.
Pharmacist Nancy Cha and the pharmacy are accused by the board of failing to ensure that the drugs they dispensed were for patients with legitimate need. They have not been implicated in the drug dealer's fraud scheme.
The pharmacy also failed to account for 12,610 OxyContin tablets with a street value of more than $1 million, the board said.
Cha's attorney, Richard Moss, said she was a well-meaning pharmacist who naively believed she was helping people in need.