[Noozhawk’s note: This article is part of Day 7 in Noozhawk’s 12-day, six-week special investigative series, Prescription for Abuse. Related links are below.]
Santa Barbara County law-enforcement officers have seen firsthand what prescription drug misuse and abuse can do to a person — physically, mentally and legally — since they not only investigate drug-related crimes but are often the first responders to the many medical emergencies involving overdoses.
Prescription medications are involved in more U.S. overdose deaths than heroin and cocaine combined, according to the Centers for Disease Control and Prevention.
And in Santa Barbara County, drug- and alcohol-related deaths nearly doubled between 2005 and 2009, to 111 from 60. During that five-year period, 350 deaths were recorded with a cause related to overdose or accident apparently influenced by the drug or alcohol use, officials say.
Prescription drugs are only legal if used for their intended medical purpose, and the Santa Barbara County District Attorney’s Office prosecutes cases of possessing, selling or transporting them.
“It wasn’t uncommon to arrest people who had just filled a bottle of Vicodin or codeine with a 30 count, and a day later it was almost all gone,” District Attorney’s Office investigator Tom Miller told Noozhawk.
“I’ve probably arrested 500 to 1,000 people who seem to have prescription drugs in their pockets,” he continued. “It was never common that they carried the bottle with them because the pills probably came from their aunt or their mother or someone else.
“As far as law enforcement goes, if you’re caught with opiates it’s the same as possession of heroin in terms of sentencing. One codeine pill would be (Section) 11350 of the (California) Health and Safety Code, which is equal to having heroin.”
Driving under the influence is a crime regardless of what intoxicating substance was consumed, and many prescription drug DUIs happen after accidentally combining drugs that badly interact, said Deputy District Attorney Michael Carrozzo.
Strong painkillers combined with antidepressants can be a dangerous mixture, he said.
“And then you have people who do it purposefully, who are addicts, who are abusing these prescriptions as well, and driving to work or driving other places,” he added.
Most people who abuse prescribed medications get them from prescriptions for family members or friends, but street sales always have eager buyers, Miller said. In some cases, he said, senior citizens have been known to sell their extra medications to supplement their incomes.
With pills or medical marijuana recommendations, people usually split them into small quantities if they’re going to trade or sell them, Carrozzo said.
Strong painkillers like OxyContin are dangerous because they’re 80-milligram tablets that have a time-release formula; that is, they are designed to deliver effects over a period of several hours.
“If you crush it, you get a huge jolt of opiate, so when you take it all at once, it’s effectively the same as taking heroin; that’s why it’s so incredibly addictive,” said Cmdr. Scott Barker, supervisor of the Santa Barbara Regional Narcotic Enforcement Team as the county’s assigned agent from the state Bureau of Narcotic Enforcement.
It also explains why the street price is $80 per pill, when Valium, Vicodin or Xanax can be purchased for as little as a five-dollar bill.
While Barker and the local law-enforcement officers assigned to his unit are aware of the prescription drug issue in the county, his team is focused on stopping the flow of illegal drugs from Mexico.
“Within the last year, we haven’t run into too many prescription drugs, but we do have a UCSB detective on our team and that’s one of the reasons he’s here,” Barker said. “There’s a lot more prescription drug use, especially OxyContin, over at UCSB.”
Legal and illegal substances have a huge impact on local crime rates. In fact, 80 percent of inmates in the Santa Barbara County Main Jail have an alcohol- or drug-related element to their crime, authorities say.
“They’re coming off the drug, getting ready to go on the drug or in the middle of the usage,” said Chuck McClain, supervisor of the Sheriff’s Treatment Program at the County Jail. “One of those three things when they committed their crime.
“So if you take away the alcohol or drugs for those folks, the crime wouldn’t have happened.”
There are many court-mandated drug-treatment programs in Santa Barbara County, but participants in the Sheriff’s Treatment Program are incarcerated inmates.
Statistics show that the program cuts the rate of recidivism — the percentage of inmates who will be rearrested after being released — to 30 percent or 35 percent for its graduates, while the rest of the jail population has a 75 percent recidivism rate.
Success rates are especially high with “door-to-door service,” when inmates get released from jail and go directly into a sober living home or other treatment facility instead of going back to their old environments, officials say.
As a 12-step program saying goes: “If you hang around a barber shop long enough, you will get a haircut,” McClain said.
The relationship between substance abuse treatment and recidivism has been drawing attention recently as Gov. Jerry Brown began implementing a realignment of California’s correctional system.
In May, the U.S. Supreme Court upheld a lower-court decision that ordered the state to release as many as 46,000 prison inmates over the next two years. Brown and the Legislature came up with a controversial plan to move the least dangerous inmates back to the counties where they were convicted.
As of Oct. 1, California began transferring responsibility for lower-level drug dealers, shoplifters and other felons deemed to be nonviolent or nonsex offenders to the state’s 58 county jurisdictions, many of which are grappling with jail overcrowding of their own.
It’s estimated that 80 percent of the incoming state inmates could require treatment on some level for behavioral, substance abuse or mental health issues. While some funding has been dedicated for sober living or treatment programs, agencies and organizations running such programs are already operating with dwindling resources.
McClain tracks the drugs of choice reported by inmates in the Sheriff’s Treatment Program, which has served more than 8,000 men and women since the program started in 1996 — providing key insight into county trends. Methamphetamines were once the top drugs but they’ve been replaced by heroin and marijuana, he said.
Meanwhile, McClain said he also has observed a significant uptick in the percentage of inmates who report prescription medications as their drug of choice, to 5 percent last year from less than 1 percent two years ago. He projects that number will increase over the next five years.
Perhaps surprisingly, he said most inmates abusing prescription drugs don’t abuse other substances.
“The majority of it is, ‘One is pretty good, I’ll try two. Two is better, I’ll try four,’” he explained. “That’s the way that’s going, and they’ll doctor shop so they can get more of what they’re addicted to.”
Substance abuse becomes an issue in probation, too, even among young people.
“If their usual drug choice is alcohol or marijuana and they know they’re going to be tested for it, they’re going to start changing to different types of drugs to get that high,” said Von Nguyen, a deputy district attorney and juvenile prosecutor.
Adolescents will often turn to prescription drugs from alcohol or marijuana, since random drug testing isn’t always comprehensive, she said.
“I can’t stress enough how many kids we see violating probation over and over and over again because they’re testing positive for marijuana,” Nguyen said.
Burglaries and robberies committed to get prescription drugs are common, in pharmacies, drug stores and marijuana dispensaries, authorities say.
Officials say adolescents steal over-the-counter cold medications that have an age requirement for purchase, and use the drugs to get high. People also steal over-the counter medications that include ephedrine, which is used in stimulants and decongestants, since it’s one molecule away from methamphetamine.
In the city of Santa Barbara, there have been at least four burglaries of pharmacies and dispensaries in the last two years, with the perpetrators taking narcotics or marijuana.
Nationwide, armed robberies at pharmacies rose 81 percent between 2006 and 2010, to 686, according to the Drug Enforcement Administration. That accounted for 1.3 million pills, mostly oxycodone-based painkillers like OxyContin or hydrocodone-based painkillers like Vicodin and Norco.
One big problem Santa Barbara County doesn’t appear to have is “pill mills,” or sham clinics that exist for the sole purpose of selling prescription drugs.
Florida is infamous as the “Pill Mill Capital” of the United States and, in June, Gov. Rick Scott signed legislation that requires prescribers to register with the state Department of Health, bans prescribing the most-abused drugs under most circumstances, and expands the state’s database that monitors distribution of prescription drugs.
Here in Santa Barbara County, the Sheriff Department is creating a tracking system to monitor what kinds of drugs — prescription, legal or illegal — are involved in cases, said Sgt. Brad McVay. That information isn’t being tracked currently, he said.
“For us, we’ve just been looking into the cause of death, but we’ve learned we do have a growing problem related to drug use,” he said.
The sheriff’s Crime Prevention Unit was dissolved after the last round of department budget cuts, and many of those duties are now being filled by volunteers. However, the department’s most successful effort at preventing prescription drug abuse and diversion remains: Operation Medicine Cabinet.
The program was launched in 2009 when the Sheriff’s Department teamed up with the county Public Works Department’s Resource Recovery & Waste Management Division. The public works agency was hopeful of preventing the drugs from ending up in the water table while law enforcement was concerned about recirculation of the pills, “so we were stuck in the same boat,” McVay said.
The county has installed drop boxes at nine sheriff’s substations throughout the county. McVay says the boxes are “constantly full” and estimates that one ton of medications are hauled out of the containers every three months.
Pills kept in medicine cabinets at home are an easy supply for adolescents as well a danger for smaller children and seniors.
“It’s affecting multiple generations,” McVay said.
The need for disposal also pops up in some unexpected ways.
McVay said people posing as potential homebuyers will often take any drugs that aren’t locked up during open houses. He and other law-enforcement officers are working with local real estate agents to encourage them to lock up medicines before opening a home to the public.
“Lock your medicine cabinet,” McVay said. “There’s no reason to have medicine out.”
If the home is a residence with a person with a known illness, he said, “any druggie can say ‘I know that’s a house with drugs in it ... It’s amazing how much locking your medicine cabinet will deter that.”