Curbing Opioid Theft and Diversion by Street Gangs and Criminals

Curbing Opioid Theft and Diversion by Street Gangs and Criminals

The opioid epidemic has been ravaging communities across the United States for years now. While there are many complex factors behind this crisis, one issue that keeps coming up is the role of street gangs and criminals in stealing and diverting prescription opioids for illegal use and distribution. This kind of theft and diversion only worsens the epidemic by putting more opioids on the streets. So what can be done to curb this criminal activity and prevent opioids from being diverted into the hands of gangs and drug dealers? Let’s take a look at some of the key strategies and solutions.

Understanding How Opioids Get Diverted

First, it helps to understand the main ways that prescription opioids get diverted into illegal channels in the first place^[1]:

• Theft from production facilities or pharmacies before prescriptions are filled
• Diversion when filling real prescriptions, such as “doctor shopping” or getting multiple prescriptions from different doctors
• Diversion after prescriptions are filled, through theft, illegal sales, etc.

Street gangs and criminals take advantage of every point along this supply chain. For example, armed robberies of pharmacies specifically to steal opioids have become increasingly common. Gangs also recruit people to pose as patients and get opioid prescriptions from corrupt or negligent doctors – this is known as “pill mills.” And of course, individual theft and resale of opioids is rampant as well.

Strengthening Supply Chain Security

Given how many weak points there are for diversion along the pharmaceutical supply chain, a key priority is strengthening security measures and preventing theft in the first place^[2]. For example:

• Better securing production and distribution facilities through measures like video surveillance, guards, and inventory controls
• Installing security features in pharmacies like time-delay safes for opioids
• Putting tighter restrictions around opioid transportation to cut down on cargo theft

Government agencies like the DEA are also ramping up regulations and enforcement around production quotas, distribution monitoring, and penalizing companies with poor controls^[5]. The idea is to tighten oversight across the board to identify and stop leaks before opioids ever reach the street.

Tracking and Monitoring Prescriptions

A major priority is also improving tracking of opioid prescriptions to identify suspicious patterns of diversion. For instance, states are implementing prescription drug monitoring programs (PDMPs) to monitor prescribing and dispensing^[3]. These databases help flag “doctor shoppers” getting multiple prescriptions, over-prescribing doctors, or unusual volumes going to specific pharmacies. Law enforcement and regulatory agencies can then investigate and intervene as needed.

There is also a push for e-prescribing and other digital systems to better track prescriptions in real-time. This makes diversion harder compared to paper prescriptions. Overall, better tracking helps agencies identify sources of diverted opioids early and cut off the supply.

Cracking Down on “Pill Mills” and Negligent Doctors

A huge source of diverted opioids are so-called “pill mills” – shady pain clinics, doctors, or pharmacies that hand out opioid prescriptions illegally or without proper oversight^[2]. Cracking down on these operations cuts off the supply at the source.

Law enforcement is getting much more aggressive about identifying and prosecuting pill mills. There are also new laws and stronger penalties against unethical doctors and pharmacists who enable diversion. Professional licensing boards are also taking negligent opioid prescribing more seriously.

For instance, Operation Pilluted led to charges against dozens of doctors and pharmacists for illegally prescribing millions of pills^[2]. These tough actions disrupt criminal pipelines and act as a deterrent to other doctors considering bending the rules.

Limiting Opioid Prescribing

In addition to tracking and enforcement, there is also a push to limit unnecessary opioid prescribing in general to reduce opportunities for diversion. For example, many states have implemented prescribing limits for acute pain or required checking PDMPs before prescribing. There are also guidelines advising doctors to avoid opioids for chronic pain when possible.

While well-meaning, these limits can make doctors reluctant to prescribe opioids even when medically appropriate. There is a balance between limiting diversion and ensuring appropriate access. But judicious prescribing based on current evidence and guidelines can help curb excess supply without preventing legitimate use.

Take-Back Programs and Public Education

Another angle is making it easier for the public to safely dispose of unused opioids rather than having them sit around vulnerable to theft. Many communities have implemented drug take-back programs or installed drop boxes for old prescriptions. DEA-run National Prescription Drug Take Back Days have collected tons of unneeded medications over the years.

Educating the public not to stockpile opioid medications or share them with others is important too. The less unused opioids in homes, the less that can potentially be diverted.

Coordinated Law Enforcement Strategies

Given the complex nature of opioid diversion, law enforcement recognizes that no single agency can tackle this alone. Coordination between local, state, and federal agencies is crucial^[4]. Task forces allow agencies to share intelligence, pool resources, and conduct joint investigations targeting key trafficking networks or operations.

For example, the DEA’s High Intensity Drug Trafficking Area (HIDTA) program coordinates multi-agency efforts in regions hard hit by trafficking. The Opioid Fraud and Abuse Detection Unit brings together federal, state, and local investigators to specifically target opioid diversion. This collaboration amplifies enforcement efforts.

Addressing Underlying Drug Demand

While critical, enforcement against diversion can only go so far if underlying demand remains high. As long as there is a huge market for diverted opioids, criminals will find ways to supply it. So a comprehensive strategy also requires addressing the root causes driving opioid misuse and addiction in the first place – the conditions creating demand.

This means improving access to evidence-based treatment and recovery services in the community. It also means addressing socioeconomic factors, mental illness, trauma, and other issues that help drive substance use disorders. A balanced public health/public safety approach is needed to reduce both supply and demand.

Harm Reduction Measures

Finally, harm reduction measures like naloxone distribution and needle exchanges are important for reducing overdoses and the spread of infectious disease – both of which are exacerbated by diversion. While not solving the problem per se, these measures mitigate the damage caused by diversion and save lives.

For example, equipping first responders with naloxone helps counteract overdoses from illegally diverted opioids. Safe injection sites provide clean needles and connect people to treatment. These pragmatic policies reduce the health impacts of diversion even as underlying efforts continue.

No Single Solution

As we can see, there is no silver bullet solution for stopping opioid diversion and theft. It requires strengthening security across the pharmaceutical supply chain, improving prescription tracking, targeted enforcement operations, coordinated law enforcement, judicious prescribing policies, public education, harm reduction, and addressing root causes of addiction that drive demand.

A collaborative, evidence-based, public health-focused approach is needed. But by taking diversion and theft by street gangs and criminals seriously, we can help mitigate this aspect of the opioid crisis and prevent countless unnecessary deaths.

References

[1] Review of the Drug Enforcement Administration’s Regulatory and Enforcement Efforts to Control the Diversion of Opioids – Department of Justice Office of the Inspector General.

[2] Evidence on Strategies for Addressing the Opioid Epidemic – National Center for Biotechnology Information.

[3] The Opioid Epidemic: Supply Control and Criminal Justice Policy—Frequently Asked Questions – Congressional Research Service Reports.

[4] Promising Strategies to Reduce Substance Abuse – Office of Justice Programs.

[5] 2019 National Drug Threat Assessment – Drug Enforcement Administration.

[6] Policing on the Front Lines of the Opioid Crisis – The Police Forum.