The program also will link pharmacies into one prescription database and state investigators will be able to track stolen or forged prescription pads
Aristide Economopoulos/The Star-LedgerShannon Fogarty sits in the cafeteria of Integrity House in Newark. She abused cough syrup and and pain pills that led her to heroin.
TRENTON — All it took was a single pill.
A friend encouraged her to try it, then a doctor prescribed it, no questions asked. A single pill of the painkiller OxyContin and Brenna-Ann Haase was hooked, so much so that she stole cash, jewelry, DVDs, anything she could use to feed her addiction. Once an energetic fifth-grade teacher, Haase ended up a felon, locked up for more than two years in state prison for robbery.
"Prior to that there was no issue, there was no addiction," said Haase, 33, of Bloomfield. "How was I to know? I smoked pot, I partied in college, but I never in a million years thought by taking one pill I would open up the door to a downhill spiral of losing everything."
With addictions to narcotic painkillers at crisis levels and overdoses killing nearly 15,000 people in the United States every year, the state Attorney General’s Office this week will announce New Jersey’s toughest effort yet to combat the problem.
Attorney General Jeffrey Chiesa on Wednesday will unveil a program to track every prescription filled in New Jersey for controlled dangerous substances such as OxyContin, Adderall and Valium, including information on patients, doctors and pharmacies.
The program will allow state investigators to target patients getting multiple prescriptions from different doctors or filling multiple prescriptions at different pharmacies. It will also identify doctors and pharmacists who approve or dispense unusually large amounts of drugs. If they are found to be prescribing the drugs improperly, they could face hefty fines, jail time and loss of their license to practice.
"Prescription drug abuse is a public health crisis, there’s no doubt about that," said Thomas Calcagni, director of the state Division of Consumer Affairs, which oversees the licensing and enforcement of doctors, dentists and other prescribers, as well as pharmacists. "If we’re ever going to make any headway in addressing the issue, everyone needs to own it."
Health care providers will have real-time access to the information generated by the new program so they can check a patient’s prescription history and detect possible addiction or abuse, as well as determine what drugs a person may be taking if they show up at a hospital emergency room for treatment.
Aristide Economopoulos/The Star-LedgerSeamus Donohue sits in his room at Integrity House in Newark. He started getting hooked on pain pills when he was in high school in Wayne Hills playing football and basketball. It led to heroin. He feels if he wasn't able to doctor shop and get more pain pills he might have not tried harder drugs.
The program also will link pharmacies into one prescription database. State investigators will be able to track stolen or forged prescription pads, and pharmacists will be empowered to check on a customer’s history at other pharmacies before giving out drugs.
"Sometimes addiction is easy to spot and other times it’s not," said Edward McGinley, president of the state Board of Pharmacy, which licenses and oversees pharmacists. "This is a welcome tool."
Aside from controlled dangerous substances, the monitoring program will track prescriptions filled for human growth hormone, which has been a focus of the Attorney General’s Office since a Star-Ledger investigation in 2010 uncovered widespread use of that substance as well as anabolic steroids among New Jersey law enforcement officers and firefighters.
The program, funded by a $300,000 federal grant, went live this month and is expected to be in full swing by spring. It is the centerpiece of an ambitious initiative authorized by the Legislature in 2007 and advanced by Calcagni to target prescription painkiller addictions and overdoses, an epidemic that kills more people every year than cocaine and heroin combined.
The division plans to make prescription pads tougher to counterfeit, to increase security at pharmacies and to bolster the number of random inspections to ensure drugs are safe. Calcagni also plans to unilaterally revoke drug privileges from doctors, pharmacists and other licensed professionals suspected of breaking the law, to expand the number of drop boxes where residents can get rid of unused drugs, and to warn parents of the dangers of prescription medication.
"Not everyone knows how addictive these drugs can be," Calcagni said, "or how quickly they can damage or destroy people’s lives."
Patti Sapone/The Star-LedgerBrenna Haase, right, and her 6 1/2 week old daughter, Gianna DeFeo, visit Haase's mother Donna Haase. Brenna Haase was a middle-class middle school teacher who got hooked on prescription drugs, which eventually sent her life into a tailspin. She lost her teaching license and is now working at a treatment facility where she went through the program and got clean.
FULL-BLOWN EPIDEMIC
Teenagers and young adults in their mid-20s with access to drugs from friends or a home medicine cabinet are particularly vulnerable. Treatment centers in New Jersey reported 7,238 admissions for painkiller addictions in 2010, 12 times more than in 2000, according to the Substance Abuse and Mental Health Services Administration. Most were white males age 21 to 25.
"These teenagers don’t have the judgment or the ability to self-regulate and to recognize when they are getting dangerously close to the cliff and they fall off," said former Gov. James E. McGreevey, who offers spiritual counseling at Integrity House in Newark.
"By virtue of the power of a doctor’s signature, there’s a seemingly tacit acceptance that the prescription is not only appropriate but recommended."
When addicts can no longer afford prescription drugs or their supplies run dry, law enforcement officials say they often turn to a cheaper and equally effective substitute: New Jersey’s ample supply of Colombian heroin.
"Prescription drugs drive drug crime in the suburbs," said Brian Crowell, the special agent in charge of the New Jersey Division of the Drug Enforcement Administration. "But what happens is when people can’t find the drugs in the suburbs, they come into the cities to buy the heroin."
Seamus Donohue was the youngest and smallest of three boys born to a family in Wayne. Slowed in school by learning disabilities, he was a freight train on the high school football field and basketball court. He played so hard he tore his knees to pieces. At 17 years old, a doctor gave him a narcotic painkiller and his entire life derailed.
Donohue said his addiction moved to acid, ecstasy, heroin and other drugs. Over the next two decades, he dropped out of college, lost a good job at Newark Airport and failed rehab 15 times. He lived out of his car in Paterson, ate out of Dumpsters, was in and out of jail and stole almost anything — even the medication from his father’s deathbed.
He said he lost custody of his son "because I was high at court."
"I felt like it progressed because once I got a taste, I liked it," said Donohue, 38, who’s now recovering at Integrity House.
"I look back now, I know it started the engine."
Andrew Mills/The Star-LedgerThomas Calcagni, director of the New Jersey Division of Consumer Affairs, in this August file photo. Calcagni plans to unilaterally revoke drug privileges from doctors, pharmacists and other licensed professionals suspected of breaking the prescription drug law.
FLUSH WITH DRUGS
Retail pharmacies filled nearly three times as many prescriptions for opium-based and narcotic painkillers such as OxyContin, Vicodin and Percocet in 2010 compared with 1991, according to the National Institute on Drug Abuse. Those numbers are expected to continue to grow as people use pills for a quick fix.
Thirty-seven states have monitoring programs similar to New Jersey’s. Though they have shown some success, there is wide agreement that they are not a silver bullet.
In Virginia, the number of people seeking prescriptions from multiple doctors and pharmacies has been decreasing in recent years, a trend attributed to the state’s prescription monitoring, said Ralph Orr, the director of the program. But to reduce the number of overdoses, the monitoring must be accompanied by education and an effort to help people get rid of unused drugs, he said. New Jersey’s effort will include those components.
McGreevey said doctors also need to use more discretion to reduce excess drug supplies.
"Today, frankly, there are doctors that are altogether generous and lackadaisical and at times inappropriate and unethical in the prescription of certain medicines," he said.
For example, in April, a physician surrendered his license after being accused of selling prescriptions for $100 out of his car in a restaurant parking lot, state records show. Pharmacists also contribute to the problem, including one who gave up her license in July after she allegedly stole more than 14,000 hydrocodone tablets from her pharmacy.
Professionals caught by the monitoring program face anything from a license suspension or revocation to hefty fines or prison time, depending on their offense.
If doctors or pharmacists identify someone they believe to be addicted to or selling prescription drugs, they will be encouraged — but not required — to refer those people to treatment or law enforcement.
STRIKING A BALANCE
Growing up in Freehold, Shannon Fogarty was the popular girl, an all-star soccer player and proud of never drinking or taking drugs to make friends.
A year after high school, a car accident launched her halfway through her windshield. A doctor prescribed a depressant for her headaches, and she wasn’t sober again for more than a decade.
When a pharmacist suspected her addiction to the headache medication, Fogarty turned to Percocet.
When that ran out, Fogarty, a veterinary nurse, began forging prescriptions from work for a liquid form of Vicodin. She was arrested five months later, when prosecutors disclosed that they had more than 300 videos of her at pharmacies getting the drugs, allegedly for her pet dog.
"There’s so many ways to get these drugs," said Fogarty, 29, now at Integrity House after a subsequent heroin addiction.
"I was a good actress, and there’s so many doctors. You’re going to find one who will give you what you want."
Doctors and pharmacists face the difficulty of balancing the needs of patients in pain with the possibility that they may be addicts or seeking drugs to sell. They also face a murky ethical question about what they should do if they identify possible problems.
"It’s my responsibility not to contribute to a person’s behavior if they are doing illegal things or abusing prescription drugs," said Mary Campagnolo, president-elect of the Medical Society of New Jersey. "But I don’t think it’s a physician’s role to get involved with law enforcement."
Victor Almeida, an emergency room doctor at Monmouth Medical Center in Long Branch, said the program will help doctors who see people so often for so many problems that it’s tough to determine if they are in pain or have an addiction. In most cases, patients are given the benefit of the doubt, he said.
"It’s hard because you don’t want to pass judgment without doing a thorough evaluation," Almeida said.
Pharmacists also fear accidentally refusing a legitimate request, said Sandra Moore, president of the New Jersey Pharmacists Association.
"It’s a good program for those who may be abusing because there’s something else being watched," Moore said. "But what about those who are not and feel like it’s an infringement on their privacy? That’s our biggest concern."
For Haase, the monitoring program might not have prevented her from becoming an addict, she said, but it could have stopped her abuse sooner. Free of drugs, she now works at Integrity House.
"My definition of an addict was a toothless person living in an abandoned building," she said. "That was always what I thought — until it became me."