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U.S. should reclassify prescription painkiller to cut rampant theft

Changing hydrocodone to a Schedule II drug means it would be kept under lock and key, requiring a pharmacist's involvement for a technician to gain access.

March 13, 2014|David Lazarus
  • A CVS pharmacy sign is displayed at a CVS store in Providence, R.I.
A CVS pharmacy sign is displayed at a CVS store in Providence, R.I. (Steven Senne, Associated…)

In his 30 years as a pharmacist, including three at a CVS Caremark store in Northern California, Wayne Wilson said it was all too common for drugstore employees to steal prescription drugs, which would often make their way to the black market.

"It happens far more often than people realize," he told me. "I used to be shocked. I'm not shocked any more."

Wilson said he personally intervened after a CVS pharmacy worker in Eureka was caught slipping painkillers into his pocket. That worker was arrested and fired, he said.

Pharmacists in other CVS stores have shared similar experiences, Wilson said, but they didn't always report such incidents to management. He said some pharmacists feared reprisal from the company for not supervising workers closely enough.

"You'd basically be reporting yourself," Wilson said.

I heard numerous such anecdotes from pharmacists throughout the state after reporting Tuesday that CVS could face as much as $29 million in fines for allegedly losing track of prescription painkillers at stores in Modesto, Fairfield, Dixon and Turlock.

Officials at the Drug Enforcement Administration and the California Board of Pharmacy said that more than 37,000 pills, primarily the generic version of Vicodin, were apparently missing. Each has a street value of as much as $10, they said.

Michele Leonhart, head of the DEA, testified before Congress last year that abuse of prescription medications "is the nation's fastest-growing drug problem."

She said there are more people taking painkillers and similar drugs for non-medical reasons — diversion, in official-speak — than there are users of cocaine, heroin and hallucinogens combined.

How do so many prescription drugs make their way to the street? Often they're obtained by people with legitimate prescriptions who choose to sell some or all of their pills. Some receive prescriptions for the same drug from multiple doctors.

In many cases, though, the pills are stolen from manufacturers, distributors, hospitals and drugstores.

As I reported Tuesday, DEA affidavits related to the missing CVS painkillers suggested that employee theft is suspected.

The affidavits said federal investigators began looking into CVS stores in California after a company employee in Rocklin, northeast of Sacramento, was spotted hiding a bottle of hydrocodone in her pants.

Hydrocodone is a narcotic painkiller sold under various brand names, including Vicodin and Norco. It's the most frequently prescribed opiate in the United States with more than 140 million prescriptions dispensed annually, according to the DEA.

"There's more hydrocodone on the street these days than in the pharmacy," said Vicken Gulvartian, a pharmacist in Hollywood. "It's an industry."

How can that be remedied?

Tighter security is one obvious answer. In 2012, drugstore chains reported 517 armed robberies of prescription meds to the DEA. They reported 851 instances of employee theft during the same period.

And that may be just the tip of the iceberg. Pharmacists say heavy workloads and limited staffing make it difficult to stay on top of what drugstore clerks and technicians are doing.

Background checks for all pharmacy employees are required by federal law. But with median pay for technicians running about $30,000 a year, some employees may find ready access to lucrative drugs too great a temptation.

"It's a challenge," said Sam Lee, who works part-time as a pharmacist at his family's drugstore in South Los Angeles and part-time at the pharmacy of a major supermarket chain. "We're just so busy all the time. It's hard to keep up."

Bill Bradshaw, a Walgreens pharmacist in Fort Worth, said there are cameras in almost all drugstores. "But they can't see everything," he said. "There are plenty of little corners where someone can hide."

Wilson, the Northern California pharmacist who worked for CVS from 2009 to 2012 before leaving for medical reasons, said surveillance cameras aren't a very effective deterrent.

"It's not like the company has someone watching what's going on all the time," he said. "They only check the tapes after they have reason to suspect someone."

Wilson also said CVS and other big pharmacy chains may be reluctant to report all instances of employee theft to federal and state authorities.

"They often like to handle things quietly, firing or suspending people," he said. "They don't want to look bad to regulators."

Michael DeAngelis, a CVS spokesman, denied such allegations.

"CVS pharmacy takes very seriously the challenge of combating prescription drug abuse and diversion to help support safer communities, and we recognize the important role our pharmacists and technicians play on the front lines of solving this problem," he said.

DeAngelis said CVS is "enhancing" its internal auditing procedures to better monitor drug inventories and is implementing "new storage and control measures for highly diverted controlled substances."

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