Recently, Massachusetts passed legislation that requires all pharmacies within the state to provide prescription drug lock boxes for sale to the public at their locations. On August 9, Massachusetts State Senate and House of Representatives passed Chapter 283 to the Acts of 2010: An Act Adding Safeguards to the Prescription Monitoring Program and Furthering Substance Abuse Education and Prevention. The legislation is the first of its kind not just for the state of Massachusetts, but the entire U.S. The bill was sponsored by Governor Deval Patrick, Senator Steven Tolman, and the Massachusetts Pharmacists Association. Section 11(b) of the legislation states that all pharmacies that dispense Schedule II, III, IV, or V prescription drugs are required to make purchasable prescription drug lock boxes readily available to consumers in order to encourage the public’s safety efforts when handling over-the-counter and prescription medications.

Prescription drug lock boxes are safe and secure locking mechanisms that cannot be tampered with without extreme force and can only be opened through its combination lock. A combination lock ensures that only the prescribed patient will have access to their prescription medications as intended, and keeps these prescription drugs from falling into the wrong hands, particularly children. Most retailed prescription lock boxes are designed to hold up to four prescription bottles and can fit within the average medicine cabinet.

Prescription drug abuse has become a national epidemic in recent years, with an alarming rate of abuse among adolescents and older adults alike. On June 3, the Center for Disease Control and Prevention (CDC) reported that 20.2% of American teenagers (1 in 5) admit to having illicitly taken a prescription medication one or more times in their lifetime. Furthermore, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 55.9% of prescription drug treatment admissions had illicitly obtained prescription medications from a friend or family member. Pain relievers, tranquilizers, stimulants, and sedatives are all highly potent drugs that can be just as toxic as street drugs when misused.

Teenagers who abuse pharmaceuticals most often obtain the drugs from their own parents’ medicine cabinets. Some teenagers may bring collections of prescription drugs to parties known as ‘pharm parties’ where multiple prescription drugs are shared among peers and often mixed with other substances such as alcohol, marijuana, or even cocaine. SAMHSA reports that the number of emergency room visits related to prescription pain relievers rose from an estimated 144,644 in 2004 to 305,885 in 2008—an increase of 111%. The abuse of opioid pain reliever medications has caused more overdose deaths in the U.S. than heroin and cocaine combined.

Even though pharmaceuticals are intended to help treat illness or alleviate pain, they are often misused for recreational purposes. Many Americans are unaware of pharmaceutical drugs’ potential for abuse, dependency, addiction, and overdose. The prevalence of prescription drug abuse has now become parallel with illicit substance abuse across the nation, affecting Americans of all regions and demographics. Prescription drug lock boxes are an effective tool for combating prescription drug abuse, and puts control right in the hands of parents to help keep their households safe. By mandating the sale of lock boxes, Massachusetts pharmacies are helping residents understand the dangers involved in handling controlled substances.

Source: PR Newswire, New Law Requires Pharmacies in Massachusetts to Carry Rx Lock Boxes, August 18, 2010

Brian Rokus of CNN writes that it can be surprisingly easy to get prescription narcotics that are highly addictive, and they’re highly profitable on the street. But detectives in Louisville, Kentucky, say most of the people they arrest aren’t in it for the money. Instead, they get pills to support their own habit, and police say they have a variety of methods for feeding their addiction.

A former nurse will use her medical training to impersonate a doctor to call in fake prescriptions to a pharmacy and simply go in and pick up her drug of choice. Others use prescription pads stolen from physicians or "doctor shop" by getting legitimate prescriptions from multiple doctors who are unaware of what other drugs their patients are already taking.

Watts sees his job as giving those he arrests a wake-up call. "If I can make this the worst day of her life so that tomorrow she will seek treatment, then I’ve won," he said. 

Kentucky is among the top states in the country for prescription pill abuse, according to the National Survey on Drug Use and Health.

"People think that, well, it’s authorized by my doctor, we can pick it up at any of the local retailers on the corner, and that prescription abuse is not really a problem," Watts said.

The vast majority of those Watts and his fellow detectives arrest start their addiction with legitimate needs for pain medication from something such as a car accident. But then they can’t stop.

That’s what worries physicians such as Dr. David Greene. "We know that narcotics are potentially addictive — we don’t know who might become addicted and who might not," he said.

Greene practices in eastern Kentucky, where he says prescription pill abuse is rampant. "It’s come to the point where there are few people who don’t have someone in their family or know someone who’s had problems with addiction, overdose or abuse," Greene said.

When patients come looking for a prescription for powerful pain medication, doctors like him are forced to determine whether the need is real or whether the patient might be an addict.

"There’s no test for pain," Greene said. "The only thing we have to go on is what they tell us, and I generally believe my patients. But most people who are going to lie to you are much better liars than you are at detecting."

One of those patients who Greene says fooled him was a 79-year-old grandmother who was selling her pills out of her nursing home.

If the patient is an addict, doctors refuse them at their own peril. In December, a man came into Dr. Dennis Sandlin’s rural clinic in Perry County, Kentucky, looking for a prescription. Sandlin demanded that he take a urinalysis test to check for drugs in his system. Later that morning, the patient returned and shot and killed Sandlin.

"My dad was writing in a chart at the nurse’s station. Someone heard my dad say, ‘You don’t want to do this. I take care of a lot of elderly people.’ And he said, ‘well you didn’t help me’ and that’s when he shot him," Sandlin’s daughter Danielle said.

Danielle is now working to raise awareness of the dilemma doctors face in prescribing pain medication. Her father, she said, was rigorous about prescribing pain medication. "He would drug test the pope if he came in asking for something."

Greene has encountered intimidating patients in his clinic as well. "Physical violence is a real fear. We have people who come in who are threatening and abusive," he said. After having one patient impersonate him, Greene no longer calls in controlled substances prescriptions into local pharmacies.

Some doctors, fearing either physical violence or contributing to addiction, have stopped prescribing pain medication altogether. That puts doctors such as Greene, who do prescribe, in a difficult position.

"No matter what you do, you’re going to have an unintended consequence," Greene said. "If you refuse to prescribe, you’ll end up with people suffering. And if you do prescribe, you’ll find patients diverting them, selling them, using them for recreation."

The solutions, police and doctors say, range from electronic prescriptions that would be difficult to forge to a national prescription database that would allow doctors to see what other drugs a pill-seeking patient is already taking.

Danielle Sandlin is pushing for some kind of reform in the wake of her father’s death. "He lost his life for something as silly as a pill."
 

Gary Hazen, 53, pleaded guilty to criminal possession and shared this with the court, "I apologize for the crimes I committed. And I would really appreciate any opportunity your honor could give me to continue my rehabilitation and to help others."

Original charges in this case included 10 felonies and eight counts of drug possession. Hazen faced the possibility of 51 years in prison and instead reached a plea agreement that resulted in the dismissal of eight of the charges.

This case first surfaced in 2007 when investigators turned their attention to Hazen after more than 50 people expressed suspicions about his interest in prescription drugs. Hazen was found to have taken hydrocodone and methadone – for which he did not possess prescriptions.

"It creeps up on you, and you don’t realize it," Hazen said. "You just don’t know it. It plays games with you. It starts with your mind. You think things differently, you start rationalizing things differently."

The toll his crimes have taken on Hazen are significant as his activities of the last 30 years were under public scrutiny. He also lost his profession and his standing in the community. For the public – they lost trust.

Hazen has a long history of serving the public in his community. From 1978 to 1998 he served as a Casper policeman. From there he spent five years as a campus supervisor for the Natrona County School District before joining the coroner’s office full time.