Editor’s Note: This article is part of a series produced by the Southwest Times Record in Fort Smith. The entire series will be published online at www.carlisleindependent.com. Next: State establishes Arkansas Prescription Monitoring Program.
Fighting prescription pain medication abuse and fraud is more than a job for detective Paul Smith, it’s a passion and constant pursuit.
When asked about his service to the Fort Smith Police Department, Smith does not talk about himself. Instead, he discusses at length the necessity to fight the ever-increasing addiction to prescription pain medications and the methods frequently used to obtain them.
"This is my passion," Smith said. "It’s so easy to become addicted to pills. You have doctors who by accident over-prescribe, and the patient become addicted, then where do they go from there? I have great empathy and sympathy for these people."
Capt. Jamie Hammond, the Narcotics Division commander for the Police Department, said Smith is invaluable in the investigation of prescription drug crimes.
"He is without question the go-to guy in this part of the state as far as prescription pill investigation, whether it be doctor shopping or pharmacy shopping," Hammond said. "Without his knowledge and professionalism, we would be completely in the dark with these investigations."
Fort Smith Police Chief Kevin Lindsey said Smith works tirelessly.
"He is one of the best subject matter experts on drugs, especially prescription drugs," Lindsey said. "He is very dedicated to doing everything he can to eradicate the problem of prescription drugs."
Smith has investigated prescription drug crimes since the late 1980s.
"There’s always been someone who has either altered or stolen prescriptions or prescription pads to get the type of substance they want," he said.
Addiction, Crime Increase
When talking with Smith about the history of painkiller abuse and fraud, Smith rarely has to dip into records for information. It’s ingrained in his memory.
"In the late ’80s and early ’90s, the prescription of choice was hydrocodone, which is a Schedule III substance," he said. "And then the mid-2000s with the introduction of OxyContin and Oxycodone, it became very popular and that’s when we see the rise in those substances being abused."
Violent crimes to obtain such drugs began to occur.
"When it came on the scene around here, we had a sharp increase in the amount of pharmacy robberies and pharmacy burglaries, because people were becoming addicted and there wasn’t enough on the street," Smith said.
"As more physicians became more comfortable prescribing those pain medications, the violence perpetrated on pharmacies subsided, but we had more people becoming addicted to it," he said. "My personal belief is that the physicians themselves were not aware of how potent of a drug they were prescribing and when they realized how addictive it was, the horse was already out of the stable."
A patient who properly consumes painkillers as prescribed would typically take one pill every 12 hours for a small amount of pain or two pills every eight hours for a medium to large amount of pain, Smith said. An addict, however, would double that amount, according to Smith.
"You have some that are so severely addicted that they are taking two and a half to three times as many required," he said. "Now the addicts bounce around from doctor to doctor to fulfill their needs."
Those who abuse the drugs often will commit fraud to feed the addiction.
"They’re going to the doctor and trying to get their pain medicine legitimately, but if they don’t get their opiate or hydrocodone (prescription), they will get a prescription for something else and alter it once they’ve left the doctor’s office, forging opiates such as hydrocodone to the bottom of the prescription," Smith said.
Some addicts also will steal to get more drugs.
"While they’re in the doctor’s exam room, when the doctor or nurse is not present, they’ll go through all the cabinets looking for prescription pads they can steal and use for forged prescriptions," Smith said.
Addicts also will steal medications from the homes of family and friends and burglarize residences where they know such drugs are located, according to Smith.
"We have seen increases in residential burglaries where no items are taken, just medications," Smith said. "If they’re at the point were they’re breaking into houses, it’s to feed their own addiction. They’re trying to find some pills somewhere to satiate their own addiction."
Hammond and Lindsey agree that prescription drug crime is major problem.
"Used to, all you heard about in the media and in television was methamphetamine, but now the biggest problem we face is prescription drug abuse," Hammond said. "A lot of people think because it’s prescribed by a doctor it’s OK, but the problem is that people don’t use them as prescribed and it’s readily available."
Painkiller abuse is a significant threat to the community, Lindsey said.
"We have a lot of drugs that are imported such as methamphetamine and cocaine, but the prescription drug problem is here and right now and is growing throughout the region of Fort Smith," Lindsey said. "We see a lot of it in our schools and other areas of the city."
Lindsey said the Police Department devotes a lot of effort into investigating pain medication crimes.
Painkiller abuse also is an increasing problem for juveniles and young adults.
"The younger crowds, 16- to 20-year-olds, are also abusing Valiums and Xanaxes," Smith said. "Kids are dying from these pills — they mix concoctions of pills and alcohol, (consume it), and it makes them tired and they fade off to sleep. They fade off into a deeper sleep and then into a coma and then eventually they die. It can happen as quickly as an hour or last two to three hours."
Smith said Xanax, Valium and hydrocodone pills are stolen from the medicine cabinets of their parents or friends’ parents.
"(And) when they get a taste for it, they go out and try to find street dealers," he said.
The most disturbing aspect of the prescription drug problem, Smith said, is 18- to 25-year-olds using syringes to inject Oxycodone.
"The OxyContin/Oxycodone was formulated for extended release," he said. "When they crush the pill and liquefy it and inject it into their veins, they are getting an instantaneous high. It’s that euphoric feeling that they are after."