| Workshops and Panel Presentations |
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Prosecuting the Prescription Provider
Tuesday, April 10, 2012, 1:00 pm – 2:00 pm |
| Moderator |
Tony Loya, Director, National Methamphetamine and Pharmaceuticals Initiative |
| Presenter |
Hon. John Niedermann, JD, Deputy District Attorney, Bureau of Specialized Prosecutions, Los Angeles County District Attorney’s Office |
| Session Description |
Celebrity deaths resulting from polypharmacy intoxication focus national attention to the prescription drug problems in the country. Prosecutions resulting from over-prescribing practices, such as the conviction of Dr. Khristine Eroshevich in the Anna Nicole Smith case, have universal appeal. Although not as publicized, these types of cases exist in every state. This session provides resources for law enforcement and prosecutorial agencies on the types of charges that can be developed against doctors and/or prescription providers.
Discussion includes the types of evidence – including medical, pharmacy and governmental records as well as individual patient information – that can be collected from both the doctor’s practice and outside sources that help prove up the prosecution’s case. Through the use of empirical examples from prosecutions (People v. Estiandan and People v. Eroshevich), attendees will witness the variety of different forms of evidence that can be assembled into a successful prosecution.
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| Learning Objectives |
1. Differentiate between the different types of evidence available to prove up criminal charges against doctors who over-prescribe.
2. Develop a logical and strategic plan in deciding what criminal charges are appropriate given the prescribing circumstances.
3. Devise a system that most efficiently preserves evidence in the fluid world of prescribing habits.
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Strategies to Prevent “Pill Mill” Diversion
Tuesday, April 10, 2012, 2:15 pm – 3:45 pm |
| Moderator |
Dan Smoot, Deputy Director, Operation UNITE |
| Presenters |
Hon. Dave Aronberg, Special Council on Prescription Drug Trafficking, Florida Office of the Attorney General; and Hon. Roger West, Assistant U.S. Attorney, Eastern District of Kentucky |
| Session Description |
Florida leads the nation in diverted prescription drugs and has become the destination for distributors and abusers through the proliferation of pill mills. Unscrupulous providers shell out prescriptions for controlled substances by the thousands, putting financial gain ahead of due diligence for legitimate patient care. Kentucky is just one state that has had to deal with the daily influx of pills from out-of-state. Enforcing the law, investigating and prosecuting cases from street-level dealers to prescribers and clinic owners can be difficult.
Through recent initiatives, Florida has made substantial progress in reducing diversion or prescription drugs and Kentucky has successfully prosecuted individuals from pill mill owners/operators to street-level dealers. This presentation provides insight into the problem and how it’s treated at the federal level. Learn techniques and strategies from experts at both the start and end of the pill pipeline. |
| Learning Objectives |
1. Define the characteristics most commonly associated with illegitimate pain-management clinics.
2. Describe the scope and impact of pill mills on increase in crime, economic costs, medical-related expenses and overdose deaths.
3. Explain successful strategies utilized by Florida’s Attorney General and Kentucky’s US Attorney’s office to combat pill mill diversion. |
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Building Cases Across State Lines
Tuesday, April 10, 2012, 4:00 pm – 5:30 pm |
| Moderator |
Tony Loya, Director, National Methamphetamine and Pharmaceuticals Initiative |
| Presenters |
Agent Bruce DiVincenzo, Delaware State Police Drug Diversion Unit; and Hon. Vernon Stejskal, Assistant Utah Attorney General |
| Session Description |
Sadly, every day thousands of people travel across state lines to shop for pills that can be resold locally for a profit. We all know this trend is increasing at an alarming rate. Successful multi-state drug diversion efforts involve the cooperation of law enforcement agencies, state attorneys general, prescribers, regulatory agencies, and state and local legislative bodies. Building cases that lead to convictions can be difficult and time consuming. In this session you will learn about successful methodologies being utilized that facilitate cooperation and information sharing among stakeholders leading to the identification, investigate and interdict trafficking pipelines.
Pharmaceutical drug diversion is fast becoming the number one drug problem across America, affecting both urban and rural communities. As offenders are commonly crossing state lines to ply their illegal drug trade, investigations and prosecutions need to keep pace to provide an effective deterrent. Investigations and prosecutions crossing state lines often present unique and challenging issues, requiring the use of all available tools as well as the development of some new ones. Participants will learn about collaborating and problem solving among and between investigators, prosecutors and other stakeholders. Participants will learn methods to overcome the artificial barriers imposed by state lines and jurisdictional boundaries. |
| Learning Objectives |
1. Evaluate the roles of practitioners, regulatory authorities, state and federal investigators and prosecutors in pharmaceutical drug crime cases, with an emphasis on how individuals and agencies can collaborate to achieve common goals.
2. Describe the evolution of the prescription pill epidemic and outline the uses and limitations of prescription drug monitoring programs to aid in multi-state investigations.
3. Identify problem areas and common roadblocks to effective multi-state investigations from a prosecutor’s perspective, with a discussion of the prosecutor’s role in working with the investigator in early case development. |
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Strategies for Successful Pharmaceutical Drug Diversion Investigations
Wednesday, April 11, 2012, 11:15 am – 12:30 pm |
| Moderator |
Hon. Jackie L. Steele, Jr., JD, Commonwealth Attorney, Kentucky 27th Judicial Circuit, and Board Member, Operation UNITE |
| Panelists |
Thomas J. Gorman, Special Agent In Charge, Louisville District Office, U.S. Drug Enforcement Administration; Christopher Kresnak, Diversion Investigator, Drug Enforcement Administration; and C. Martin Redd, Diversion Group Supervisor, Louisville District Office, U.S. Drug Enforcement Administration |
| Panel Description |
Between 2007 and 2009 the rate of diversion and abuse of controlled prescription drugs more than doubled, according to the 2010 National Drug Threat Assessment. Opioid pain relievers were the most commonly diverted drugs. Pharmaceutical drug diversion investigations can be some of the most complicated and challenging cases for investigators. Successful cases require close coordination between law enforcement agencies at the local, state and federal levels, as well as close coordination with various regulatory boards.
Participants in this session will learn investigative strategies from case studies of successful prescription drug diversion investigations, focusing on strategies that target rogue doctors, pharmacies and clinic owners. Attendees will receive information regarding criminal and/or civil actions. A question-and-answer session on effective investigative strategies will be conducted. |
| Learning Objectives |
1. Examine reasons for the increasing rate of diversion and abuse of controlled prescription drugs.
2. Evaluate effective strategies for drug diversion investigations.
3. Describe opportunities for law enforcement agencies to collaborate with regulatory agencies during drug diversion investigations. |
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Regulatory and Law Enforcement Roles in Cross-State Border Diversion
Wednesday, April 11, 2012, 1:30 pm – 3:00 pm |
| Moderator |
Richard R. Rosky, Assistant Director of Training Programs, National Methamphetamine and Pharmaceutical Drugs Initiative |
| Presenters |
William Benson, CFE, Assistant Director, Tennessee Bureau of Investigation’s Drug Investigation Division, member, Appalachia High Intensity Drug Trafficking Area (AHIDTA) Executive Board; Jon Marshall, Medical Investigator, Kentucky Board of Medical Licensure; and Karen Matthew, MA, Director of Investigations and Inspections, North Carolina Board of Pharmacy, former investigator, North Carolina State Bureau of Investigation |
| Session Description |
This session focuses on the knowledge and experience of law enforcement and regulatory agencies in addressing the prescription drug abuse epidemic, including investigations of pill mills, doctor shopping rings, and drug diversion by health professionals; interstate initiatives to address cross-state border diversion of controlled substances; and the use of data from prescription monitoring programs to enhance law enforcement and regulatory initiatives.
Examples of diversion of prescription controlled substances for self-use or to sell by health care professionals will be shared along with a description of how these issues are investigated and resolved through professional discipline, criminal prosecution and other means. Discussion will include the growth of prescription drug abuse and diversion and how use of PMPs can assist in collaborative multi-state investigations of questionable prescribing and dispensing practices. |
| Learning Objectives |
1. Define the roles of local, state and federal agencies during investigation of inter-state drug trafficking to produce prosecutable cases ending with convictions.
2. Describe and provide examples of diversion methodology for both self-use and illegal resale of controlled substances.
3. Describe the value of establishing cross-state prescription monitoring programs. |
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Building Community Support for Law Enforcement
Wednesday, April 11, 2012, 3:15 pm – 4:45 pm |
| Moderator |
Hon. Jackie L. Steele, Jr., JD, Commonwealth Attorney, Kentucky 27th Judicial Circuit, and Board Member, Operation UNITE |
| Presenters |
Officer Cully Desmond, McMinnville Police Department; Rebecca Heuser, Prevention Coordinator, Yamhill County Oregon; Mike Mayer, President & COO, MedReturn, LLC; and Dan Smoot, Deputy Director, Operation UNITE |
| Session Description |
Law enforcement deals with the prescription drug issue on the front lines. But focusing on investigations will not solve the problem alone. Community-oriented policing is a key strategy in effectively reducing prescription drug abuse. Participants will learn proven strategies on how law enforcement can engage and utilize key community partners and leaders, existing anti-drug coalitions, pharmacies, and health care professionals.
In addition, law enforcement will learn strategies on working with local schools to implement evidence-based programming and create effective policy regarding drug violations and truancy. Another successful strategy is through the preparation of ready-to-use community education kits through collaboration with non-law enforcement stakeholders. This presentation will include a step-by-step approach to developing and implementing these programs within any community. |
| Learning Objectives |
1. Outline drug abuse prevention and intervention strategies relevant to all communities.
2. Describe the creation and implementation of community education kits as an effective means of engaging multiple stakeholders.
3. Explain opportunities for law enforcement officials to enlist community partners in developing education and prevention strategies. |
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