A new Washington County initiative aims to protect the population from prescription drug abuse and diversion.
One Washington County Sheriff's Office deputy will be assigned to the Drug Enforcement Administration (DEA) Tactical Diversion Squad (TDS) to tackle the growing problem of pharmaceutical addiction and abuse.
After kicking off the Drug Take Back program in 2010, Washington County residents were dropping off significant amounts of drugs that it became even more evident that it's a significant problem in every corner of the county.
"There are regularly people coming in with large grocery or plastic bags full of narcotics that they're dumping in," Sheriff Bill Hutton said. "In the past, those narcotics would be at home, unsecured and obviously that's where the abuse would occur."
Hutton said assigning a full-time deputy to the TDS is one of many steps the Sheriff's Office is taking to help reduce statistics that show pharmaceuticals are as much of a problem as methamphetamine, cocaine, heroin and marijuana use.
"Pharmaceuticals is right up there with people abusing them as well," he said.
The TDS will be tasked with investigating the diversion, illegal distribution and the theft of pharmaceutical drugs by patients, doctors, pharmacies and other health care providers.
Hutton said many of the people abusing pharmaceuticals are starting out with prescription pain killers because of their easy accessibility before resorting to illegal drugs to satisfy an addiction they've already established.
"They're not getting the high that they need anymore from pharmaceuticals," he said. "Then they turn to heroin."
Methadone then enters the picture, Hutton said, noting that Washington County has recently seen a number of methadone overdoses that have led to criminal charges.
In January, a 21-year-old Oakdale woman was charged with murder in connection with the overdose death of a 23-year-old Scandia, Minn. man, after being accused of selling him methadone.
The man died in August last year of what a medical examiner ruled "acute methadone toxicity."
Law enforcement officials continue to warn residents of controlled substance diversion and that it makes them responsible for whatever may happen to the person receiving the drug, including the death of that person.
"The ultimate goal is to get the pharmaceuticals off the streets," Hutton said.
Even law enforcement itself is not immune to the problem. In February, Washington County Sheriff's deputy Ricky Gruber was charged with, among other things, illegal possession of pharmaceutical drugs after allegedly stealing drugs from the department's drug take-back bin.
Dr. David Frenz, medical director for HealthEast Mental Health and Addiction Care, one of the largest treatment centers for opiate disorders in the state, said a lot of patients start out with recreational use of pills.
Many of his patients are in their late teens to early 20s who first got medication out of their parents' medicine cabinets before looking for other ways to get high.
"Then pills weren't available or became expensive, so they've sort of gravitated toward heroin," he said. "Heroin right now is a bargain compared to pills on the street."
Although a lot of people have legitimate medical problems, some quickly develop an addiction.
A study published in the European Journal of Pain in 2007 lists the risk of addiction to pain killers at 5 percent.
But another study published in the Society for the Study of Addiction, considers risk factors like age, pain, depression and medication, which then increase the risk of lifetime addiction to 36 percent.
"One of the most common problems in our society is chronic low back pain," Frenz said. "A percentage of patients will develop addiction to the pain medication."
The former family medicine physician said doctors need to follow appropriate protocols and test every patient who's on narcotics to determine abuse or misuse.
"They don't do enough due diligence," Frenz said of doctors. "It's not all that hard to get controlled substances from multiple providers. A lot of it falls back on the physicians not having the safeguards in place to detect diversion."
The Minnesota Prescription Monitoring program, which allows all pharmacists and medical providers to check patients' prescription drug history to determine if they're seeing multiple doctors for the same narcotics, kicked off two years ago but is not required or statutorily regulated.
Before then, physicians relied on other providers keeping them up-to-date on medical history or patients' drug activity.
"Before the Minnesota Prescription Monitoring program became available, I thought I knew patients well," Frenz said. "I was getting burned."
A lot of the patients were doctor shopping, he said, and he was only one of the doctors from whom they were getting their fix.
Frenz explained that many emergency room physicians also believe they're doing the right thing by limiting the number of pills they're prescribing, whether it's Percocet, Oxycontin or Valium.
"And say 'What's the big deal?'" he said. "The big deal is you're not the only person they're seeing. Twenty here, 30 there, 50 there, can add to a lot of tablets in a hurry."
Dr. Kelley Jewett, a family medicine physician at the HealthEast Roselawn clinic in St. Paul, said addiction has much bigger underlying problems that link to socioeconomics.
"Look at why is there a demand for drugs on the street," she said, noting that depression, untreated mental illness and unemployment can all be reasons for buying and selling drugs.
"Unless we address the underlying issues, I don't think these problems are going to go away," she said.
Jewett also said doctors need to do their part in getting to know the patients, advising them on the proper use of narcotics and helping them understand their level of pain.
"A lot of it is educating our patients - there is some pain that's never going to go away," she said. "That if you take narcotics long enough they actually cause you more pain and they're not helping anything."
Hutton is hopeful the new initiative will yield positive results and become as successful as the Drug Take Back program.
The goal of the TDS and Washington County's involvement is to get to the bottom of prescription drug abuse and conduct thorough investigations.
"We end up having contact with the individual, we try to get it to the next step and then the next step," Hutton said. "There is obviously a large scale drug thing happening but it has to start somewhere."