The Pitt County Sheriff’s Office is paying more attention than ever to prescription medication fraud and diversion, issues that Sheriff Mac Manning thinks are growing problems in the county and nation, some on his staff said.

Illegal handling of prescriptions and prescription medications — stealing them, fraudulently using prescriptions, forging them, “doctor shopping,” and other illegal activities such as diversion of medications from their prescribed use, strength and dosage to other, non-prescribed uses — is a difficult crime to detect, control and diminish, his crime experts said. It is common across the country, it is on the rise and it is costly.

Drug diversion can take money from everyone who purchases health insurance, said Det. Gentry Pinner, a member of the sheriff’s narcotics unit who has been specializing in prescription fraud and illegal drug diversion since 2006.

Bogus claims cost health insurance companies up to $72.5 billion a year involving opioid use alone, according to the Coalition Against Insurance Fraud, in a December, 2007 article titled, “Prescription for Peril.”

The detective said he opens at least one new diversion or fraud case a week, but each case may involve a dozen or more incidents connected to a suspected abuser.

With the help of some state grants, Pinner recently got a partner to shoulder some of his caseload.

The grant is part of an education and awareness campaign to slow the growth of prescription medication fraud in Pitt County, said Melissia Larson, the sheriff’s crime analyst and grant writer.

“We received a two-year grant providing $46,000 each year from the Governor’s Crime Commission,” Larson said.

A second grant of $10,000 came from National Association of Drug Diversion Investigators, made possible from funds through the Purdue Pharma pharmaceutical corporation to local law enforcement agencies, Larson said.

Detectives approach the problem from many angles because it comes at them that way, Pinner said.

Prescription forgery is the most common form of fraud the detectives battle, Pinner said. It often begins at an emergency room or urgent care center. A complaint of pain will result in a prescription, but it will typically be a small number of pills intended to last a patient until a primary care physician is found.

That’s where forgery comes in. Changing the number of pills prescribed is common, said Charlene Peden, a pharmacist at Home Town Discount Pharmacy on Greenville Boulevard.

“Adding one zero can change a prescribed amount of 10 tablets to 100 tablets, or they can alter it to put in whatever drug they want,” Peden said.

Her years of experience, familiarity with doctors and customers, and just being at one place for many years, all give her an edge in looking for signs of fraud, she said.

Doctor shopping is a deception technique that doesn’t involve prescription forgery.

It involves requesting care from multiple physicians without disclosing to one doctor the care being given by another. Patients seek a prescription from each.

There is no network among doctors and pharmacy retailers to monitor people’s scripts when submitted, Pinner said.

“I don’t know yet how we can get involved at the actual point that a medication is prescribed,” he said.

Internet pharmacies also are source of drug fraud, Pinner said.

In 2006, the Office of National Drug Control Policy identified 34 rogue Net pharmacies that dispensed more than 98 million dosages of hydrocodone. On average, it would take 1,118 pharmacies to dispense that amount of dosages legally, Pinner said.

A new and dangerous phenomenon, popular among youth, is “pharming parties,” he said.

Partygoers arrive with pills they have taken from family medicine cabinets, toss them into a bowl, then ingest whatever they happen to pick out of the bowl, he said.

“You can go to YouTube and find video uploads where kids share stories about this stuff,” Pinner said.

While the problem of drug diversion and prescription fraud is big and getting bigger each year, resources and funds get smaller as the economy shrinks. But efforts are being made to combat the problem on different fronts, Pinner said.

Many pharmaceutical firms are trying to make pills tamperproof, so if they are crushed by an abuser for a stronger and more rapid effect, they will be rendered useless.

North Carolina has a controlled substance reporting system, a database of names submitted by pharmacists that doctors can check if they suspect a patient of doctor shopping or other types of abuse.

The state includes drug diversion training among a list of specialties which law enforcement agencies may choose to implement at local levels, Pinner said.

He said it is difficult to track the extent of abuse because law enforcement agents can only account for those people reported to them for investigation. The issue of undetected fraud is a delicate one for Pinner, because the success of his work depends almost completely on the good working relationships he forms with pharmacists.

“Most of the people I deal with as offenders are people who just made a bad decision to get involved with prescription forgery through an addiction that developed from what was an attempt to control real pain legitimately that got out of hand,” Pinner said.

Courts consider factors such as patterns of abuse, numbers of offenses committed and available treatment options, he said.

Legwork and phone calls are a staple of Pinner’s daily operations, he said.

“We’ve found that the more often detectives visit a pharmacy, the more likely a pharmacy is to call and report suspicious activity,” Pinner said.

The sheriff’s office also will continue its “Operation Medicine Cabinet,” which collected more than 30,000 dosage units of unused and old prescription medications dropped off by the public in 2009.

Pinner said he follows the lead of Manning, who he said has taken a strong interest in this issue.

“He knows it’s serious,” the detective said.

Contact Michael Abramowitz at mabramowitz@reflector.com or (252) 329-9571.