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Monday, April 25, 2011

Letter From Chief Horner

First, I would like to thank Diane Rehm for being given an opportunity to participate in the discussion of the prescription drug abuse epidemic facing the United States. I would also like to express my appreciation to ABC’s 20/20 and Lynn Sherr, who, in 2001, attempted to describe ground-zero of the prescription abuse epidemic. In the 20/20 piece,, OxyContin was described as “the single most dangerous drug, for law enforcement, on the street”. I would like to extend a very special thank you to Sabrina Travernise of the New York Times, who recognized the pain and suffering in Portsmouth and Southern Ohio, created by the “pill” epidemic. She chose to travel to Portsmouth, to meet with those impacted and who are attempting to become “the wall” against prescription drug abuse. I had the opportunity to meet with her. She sat and listened to my catharsis, a long history of witnessing and attempting to combat the problem. Given the restrictions she faced on telling our story in a finite space in the New York Times, she wrote, in my opinion, an exceptional piece of journalism.
I will begin with an explanation of my background and the authority which I speak on the “pill” epidemic. I have been a Police Officer for 28 years, approximately 10 of which was commanding a local drug task force (approximately 1990-2000), and approximately 9 years as the Chief of Police. Throughout the 28 years, my primary focus has been to help address the problem of drug abuse.
Early in my career, I observed that the abuse of prescription medication was becoming an increasing problem for law enforcement. During my tenure with the drug task force, then Scioto County Assistant Prosecutor Rick Brown and I would provide a drug orientation for new Grand Juries. Inevitably, with virtual every Grand Jury, the question would be asked, “What is the number one drug problem in our community.” Much to their dismay, our response was pharmaceutical drugs. In the early, 1990’s we observed a transition that would later define prescription drug abuse in Portsmouth, Scioto County and later the nation. We watched as a local physician realized the potential profit derived from the “legal” prescribing of prescription medications. Throughout the 1990’s other physicians followed his lead. Office employees would later realize that they, too, could make this a profitable enterprise. New “pain clinics” would spring up and would begin drawing upon contract physicians from other states.
In approximately 2000, the local drug task force was astounded, as a local orthopedic physician would make the transition to “pain management”. A convicted felon would become the office manager. Lines would form, stretching down a city block. Vehicles would appear with license plates from as far away as Texas. Van loads of people would arrive. Pizza would be ordered and groups would have lunch together.
Portsmouth is located on the Ohio River, approximately 100 miles south of Columbus and approximately 100 miles east of Cincinnati, the closest Drug Enforcement Administration Offices. Following public outcry, the local task force made the decision to dedicate all their manpower, 4 officers, fulltime, for approximately 4 months to investigating the physician. Working with the Ohio State Pharmacy Board and the Ohio Bureau of Criminal Identification and Investigation, the investigation concluded with the exchange of OxyContin prescriptions for automatic weapons. Search warrants were executed and approximated $400,000 dollars was recovered in the basement of the home of physician, with another approximately $70,000 being located in an apartment next to the physician’s office. The physician was charged on a multi-count indictment, including the Ohio “RICO” statute, Engaging in a Pattern of Corrupt Criminal Activity. He later pleads, forfeits his assets, and is sentenced to a prison.
OxyContin, which was prescribed by the physician describe above, was approved by the FDA and began sales in approximately 1995. By 2001, Purdue Pharma’s profit from the sale of OxyContin was believed to be over one billion dollars. As the early 2000’s progressed and as overdoses proliferated, lawsuits would be filed against Purdue Pharma. It was reported that a company’s news release was “65-0”: OxyContin cases against Purdue Pharma dismissed at a record rate.” It was reported that Howard Udell, an attorney for Purdue Pharma, called the lawsuits “absurd”.
Some believe Purdue Pharma initiated “unholy alliances” with some of their most vocal critics in law enforcement. It has been reported that many elected officials, along with law enforcement, who once fought the OxyContin epidemic, were reported to have been hired by Purdue Pharma and operated as paid employees of the company, touting OxyContin’s safety and effectiveness. Some individuals expressed concern about Purdue Pharma’s association with law enforcement associations.
By 2004, it was reported that over 120 lawsuits had been dismissed. Earlier, the United States Attorney’s Office had initiated an investigation into the conduct of Purdue Pharma and OxyContin. Sales of OxyContin declined, somewhat, in the following years.
For the first time in 2006, unintentional poisonings exceeded motor vehicle accidents as the overall leading cause of injury in Ohio. Ohio death rates from unintentional poisoning, exceeds deaths from falls, motor vehicle accidents, homicide, suicide, and firearm related deaths. I do not want to lessen or downplay the significance of our losses, but more people died from 2003-2008 as a result of unintentional drug poisonings in Ohio than the number of U.S. military losses in the Iraq War and the 911 attack on the World Trade Center, respectively. Unintentional fatal drug poisonings have quadrupled over the past ten years. Scioto County is included in the “Top Ten Counties in the Nation” for illegal prescription trafficking.
In 2007, with the risk of substantial fines and criminal sentences, Purdue Pharma entered into a plea agreement and agreed to pay 6 million dollars in fines (proverbial, cost of doing business?), a significant amount until you jump forward two years, when it is believed profits from the sale of OxyContin would exceed 3 billion dollars. Executives of Purdue Pharma entered into plea agreements and agreed to pay fines of 34 million dollars. However, the executives avoided criminal sentences. (Why?)
From 2007 to present, overdose death rates have soared and crime believed to contributable to prescription drug abuse has soared. The human and financial costs are tremendous, with the estimated direct and/or indirect cost of unintentional fatal poisonings to the State of Ohio being estimated at 3.6 billion dollars.
Scioto County, Ohio has the highest hepatitis rate, contributable in large part to pharmaceutical intravenous injections. Scioto County has the third highest rate of unintentional poisoning deaths in the State of Ohio, surpassed only by two adjacent counties. Rehabilitation and treatment requests are at an all time record high. Scioto County has been ranked lowest of 88 Ohio counties in “health outcomes” by the Ohio Department of Health (2009). One in ten babies is born with addiction, described as “crack babies of the 2000’s.” Crack cocaine traffickers from major metropolitan areas, including Detroit, Michigan, are finding increased profit and decreased risk in the transportation and sale of OxyContin and are targeting communities like Portsmouth, Ohio.
Throughout my career, I have stated that “the drug problem” is not a police problem alone, it is a community problem. In 2009, after the infiltration of Portsmouth and Scioto County with as many as 9 “pain clinics” or “pill mills”, the citizens of Portsmouth and Scioto County decided it is a “community problem”. Following a pharmaceutical drug abuse town hall style meeting in 2009, citizens stepped forward to partner with law enforcement to attack the pill epidemic and become the “WALL” against prescription drug abuse. The Scioto County Rx Drug Action Team was created. For the first time in the history of Scioto County, Dr. Aaron Adams declared a health emergency, partnering with Portsmouth Health Department Register Nurse Lisa Roberts, Porter Township Trustee Bob Walton, Jr., Coroner (now Ohio Representative) Terry Johnson, Frank Thompson (Website Author: All Things Wildly Considered) and Counseling Center Director Ed Hughes, among others, including law enforcement, education and faith-based organizations to become the “David against Goliath”, believing the coming war to be of biblical proportion. As a result of, or directly related to the formation of the Scioto County Rx Action Team, the families of those who have lost loved ones to the prescription medication epidemic form SOLACE, “Surviving Our Loss and Continuing Everyday”.
In 2010, hearing the “cry in the dark” of southern Ohio, then Governor Ted Strickland formed the Ohio Prescription Drug Abuse Task Force bringing to the table, probably for the first time in Ohio history, a Task Force comprised all disciplines involved or impacted by the prescription pill problem, including pharmacists, doctors, health care, treatment and rehabilitation, legislative, law enforcement, and many others. Throughout 2010, the Task Force met, debated and cooperative arrived at recommendations that were presented to the Governor. With the election of Ohio Governor Kasich, Ohio Attorney General Mike DeWine, and Ohio Representative Terry Johnson, the torch was picked up, resulting in a unified effort, not only at the local level, but also at the State level. Legislation (Ohio House Bill 93) has been enacted to addresses prescription abuse issues in Ohio. Today, United State Senator Sherrod Brown, United States Senator Rob Portman, United States Attorney Carter Stewart, and the Drug Enforcement are partnering with the people of Portsmouth, Scioto County, Southern Ohio and the United States to combat the prescription drug abuse epidemic.
I would like to present the following for consideration:
We must hold each other and our leaders accountable.
We must say things that need to be said, regardless of the political correctness, so we can learn, understand, grow and unite.
We cannot afford “NOT” to pay the cost of this fighting the war on the illegal abuse of prescription medication.
We must take a multi-discipline, multi-faceted approach to addressing the epidemic.
We must insure patient rights to “legitimate” pain management.
Education and rehabilitation are critically important, but will results take 50 years, as did tobacco use.
More citizens have died from opioid overdoses than have died from heroin and crack combined.
Seatbelt use success resulted from forced compliance.
We must hold those responsible, severely accountable, up to and including treatment of these groups as organized criminal enterprises, prosecuting under state and federal RICO statutes. In all likelihood, opioid prescriptions have cause more deaths than any mafia or cartel combined.
We must provide the assets to law enforcement to combat prescription drug abuse, especially “kingpins” and organized enterprises.
We must address media desensitization of prescription pill use. An example being Showtime series Nurse Jackie, portraying prescription medication a candy, glamorizing its use, and trading sex for pills, effectively prostitution.
If your community thinks it does not have a prescription pill epidemic, you are wrong. If you are right, it is coming to a town near you and soon.
As a community and a country, we must return to values, family, religion and unity. As a result of the incredible profits being generated by the “legal over-prescribing” and “illegal prescribing and sale of” prescription medication, should the dollar bill be imprinted with “In Pills We Die” instead of “In God We Trust”?
We have described past generations as “Generation X” and Generation Y”. What legacy will we leave our children, “Generation RX”?
In closing, there has been much said about Portsmouth, Scioto County, Southern Ohio, and Appalachia. I was a military dependent and had the opportunity to see a large part of the United States and the world. I attended Ohio State University. I chose to come back to Portsmouth and enter public service. I love Portsmouth and Appalachia. We are a strong, hard working and a faith-based people. We are a diverse community, with a proud history and heritage. There is no question we are hitting bottom. However, we must remember that sometimes we must hit bottom to begin the “recovery”.
We believe in justice (not “just us”) and today we are becoming a “united community”, becoming a “united State” and becoming, “united States” fighting a common terrorist, “Prescription Pill Abuse”. I would like to thank my associates, especially Registered Nurse Lisa Roberts and Frank Thompson, and those not listed, for providing me some of the information above.
I am proud of the Scioto County Rx Drug Action Team, the City of Portsmouth, Scioto County, and Southern Ohio for standing tall, being the “Tip of the Spear” and making a difference!  

Charles H. Horner
Chief of Police
Portsmouth, Ohio

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