Drug Enforcement Administration
Greater Kansas City Chapter
American Society for Pain Management Nursing
October 24, 2015
Judy R. Williams
Group Supervisor
Kansas City District Office
(913) 951-4108
Judy.R.Williams@usdoj.gov
Outline of Topics
Mission Statement
Illicit Drug Use
Most Commonly Diverted Controlled Substances
DEA’s Closed System of Distribution
Methods of Diversion
Case Study
DEA Mission
To prevent, detect, and
investigate the
diversion of controlled
substances from
legitimate sources
while Ensuring an adequate
and uninterrupted
supply for legitimate
medical and scientific
purposes.
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Current Users
ANY ILLICIT DRUG:
22.6 million
(8.7 % of population)
MARIJUANA: 17.4 million
Rx Drugs: 7 million
COCAINE: 1.5 million
METHAMPHETAMINE: 353,000
HEROIN: 239,000
1SOURCE:
2010 National Survey on Drug Use and Health (NSDUH) published Sept 2011 by the
Dept of HHS / Substance Abuse and Mental Health Services Administration (SAMHSA)
Numbers in Millions
Current Drug Users Age 12 & Older
Past Month Illicit Drug Use among Persons
Aged 12 or Older, by Age
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Regulations:
Scheduling of all controlled substances
Under the Controlled Substances Act, all
controlled substances, legal or illegal, are
Scheduled
Five established Schedules (I-V)
Placement on Schedule depends on the drug’s
potential for abuse and accepted medical use
Different regulations apply depending on the
drug’s Schedule
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Regulations:
The Controlled Substances Act
Title 21, United States Code
Title 21, Code of Federal Regulations
“Except as authorized by this
subchapter, it shall be unlawful
for any person knowingly and
intentionally to . . . distribute or
dispense . . . a controlled substance.”
21 U.S.C. § 841(a)(1)
.library.unt.edu
Regulations:
Applying criminal sanctions to doctors
“Registered physicians
can be prosecuted under
[21 U.S.C.] 841 when
their activities fall
outside the usual course
of professional practice.”
United States v. Moore
423 U.S. 122 (1975)
Regulations:
Applying criminal sanctions to pharmacists
“[I]f the drug-dispensing
pharmacist knows that a
customer not only lacks a valid
prescription but also will not
use the drugs for legitimate
medical purposes, then section
841 applies in full flower and
treats the dispenser like a
pusher.”
United States v. Limberopoulos
26 F.3d 245 (1st Cir. 1994)
Regulations:
Registration of physicians
Every person who distributes
or dispenses any controlled
substance must obtain a DEA
registration number issued by
the Attorney General; renewed
every 1-3 years
Prerequisites include:
(1) valid medical degree
2) valid state medical license
www.computerrepairschool.com
21 U.S.C. § 822(a)
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Regulations:
Recognition of medical need for drugs
The Controlled Substances
Act recognizes that many
drugs have “a useful and
legitimate medical purpose
and are necessary to
maintain the health and
general welfare of
www.house.gov
the American people.”
21 U.S.C. § 801(1)
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Regulations
Issue of Prescription
Controlled substances
may be distributed
lawfully by prescription
IF the prescription is
issued for a legitimate
medical purpose by a
practitioner acting in the usual course of
professional practice
21 C.F.R. § 1306.04 (a)
Most Commonly Diverted
Controlled Substances
How big is the problem?
www.ipoh-online.com.my
3.9 million people in the
United States (1.7% of the
population 12 years of age or
older) abuse prescription
drugs
* This is nearly twice the percentage of people
who abuse cocaine, crack, and heroin
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Most Commonly Diverted
Controlled Substances
How big is the problem?
Highest risk group for abuse of
prescription drugs are between 18
and 25 years of age
www.studentventure.com
Women twice as likely as
men to develop addiction
to sedatives and/or
tranquilizers
www.carisoprodol-pills-online.com
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Why the Increase in Rx
Drug Abuse?
A confluence of factors…
 Significant Increases in the volume of Rx’s
Issued
 Increases in availability
 Aggressive Marketing by Industry
 Proliferation of Internet Pharmacies
 Greater Social Acceptability for medicating a
growing number of conditions
Source: Testimony of NIDA, July 2006
www.drugabuse.gov/testimony/7-26-06testimony.html
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• Why are these
people always
outside in
separate tubs?
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Sedatives
Stimulants
Tranquilizers
Narcotic Pain Relievers
SOURCE: 2009 National Survey on Drug Use and Health (NSDUH) published Sept 2010 21
Dept of HHS / Substance Abuse and Mental Health Services Administration (SAMHSA)
DEA’s Most Wanted:
Commonly Diverted Controlled Substances
Schedule II
Oxycodone
(OxyContin;
Percocet; Tylox;
Percodan)
* Street value
$1-$5 per mg
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OxyContin
®
 Controlled Release formulation of C2
Oxycodone
 Similar to morphine in its effects and abuse /
dependence potential
 ‘Hillbilly Heroin’ - addiction, crime and fatal
overdoses have all been reported as a result
of OxyContin® abuse
 AKA OC’s, Killers, Oxycoffins, Oxycotton
 The controlled release method of delivery
allows for a longer duration of drug action so
it contains much larger doses of oxycodone
 Abusers easily compromise the controlled
release formulation by crushing the tablets
for a powerful morphine-like high
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DEA’s Most Wanted:
Commonly Diverted Controlled Substances
Schedule II
Methylphenidate
(Ritalin)
* Street value
$8-$10 per pill
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