The author(s) shown below used Federal funds provided by the U.S. Department of Justice and prepared the following final report: Document Title: Research on Illegal Prescription Drug Market Interventions Author(s): Meg Chapman, Christina Dyous, Jared Edgerton, Kimberly Francis, Dana Hunt, Sarah Jalbert, Thomas Maloney, Douglas McDonald, Katie Schlebecker, Michael Shively Document No.: 248905 Date Received: June 2015 Award Number: N/A This report has not been published by the U.S. Department of Justice. To provide better customer service, NCJRS has made this federally funded grant report available electronically. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. Research on Illegal Prescription Drug Market Interventions Final April 1, 2015 Prepared for: Office of National Drug Control Policy (ONDCP) Prepared by: Abt Associates 4550 Montgomery Avenue Suite 800 North Bethesda, MD 20814 This document is a research report submitted to the U.S. Department of Justice. This report has not been published by the Department. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. CONTENTS Table of Contents Acknowledgements ..................................................................................................................................... ii Introduction ................................................................................................................................................. 1 Illegal Prescription Drug Threat ............................................................................................................... 2 What are Controlled Prescription Drugs? ........................................................................................ 3 What is Diversion? ........................................................................................................................... 5 Unscrupulous Physicians and Pharmacists ............................................................................ 5 Doctor Shopping .................................................................................................................... 5 Sharing or Selling Pills Obtained Legitimately ..................................................................... 6 Prescription Forgery ............................................................................................................... 6 Thefts and Robberies ............................................................................................................. 7 Smuggling .............................................................................................................................. 7 Uncontrolled Internet Sales .................................................................................................... 8 National Response ..................................................................................................................................... 10 High Intensity Drug Trafficking Areas (HIDTA) Program ........................................................... 12 Intelligence and Information Sharing Initiative ................................................................... 13 Support Initiatives ................................................................................................................ 15 Enforcement Initiatives ........................................................................................................ 18 Prescription Drug Monitoring ........................................................................................................ 27 PDMP Functionality ............................................................................................................ 28 Law Enforcement Access..................................................................................................... 31 Unsolicited Reporting .......................................................................................................... 35 Conclusions ................................................................................................................................................ 37 References .................................................................................................................................................. 38 List of Table/Figures Table 1. PDMP Characteristics ................................................................................................................... 29 Table 2. Law Enforcement Access to PDMP Data ..................................................................................... 32 Abt Associates Research on Illegal Prescription Drug Market Interventions: Final ▌pg. i This document is a research report submitted to the U.S. Department of Justice. This report has not been published by the Department. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. ACKNOWLEDGEMENTS Acknowledgements This report was prepared for the Office of National Drug Control Policy (ONDCP), Executive Office of the President, by Abt Associates Inc. Contributors and reviewers at Abt Associates, listed alphabetically, include Meg Chapman, Christina Dyous, Jared Edgerton, Kimberly Francis, Dana Hunt, Sarah Jalbert, Thomas Maloney, Douglas McDonald, Katie Schlebecker, and Michael Shively. The report was reviewed by ONDCP and Linda Truitt from the National Institute of Justice (NIJ). The information contained herein does not necessarily represent the opinions or policies of ONDCP, NIJ, any agencies of the U.S. Department of Justice, or Abt Associates. Abt Associates Research on Illegal Prescription Drug Market Interventions: Final ▌pg. ii This document is a research report submitted to the U.S. Department of Justice. This report has not been published by the Department. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. INTRODUCTION Introduction This study was requested by the National Institute of Justice (NIJ) and funded in partnership with the Office of National Drug Control Policy (ONDCP) through the FY2014 Performance Management Process (PMP) Audit Service Contract for the ONDCP High Intensity Drug Trafficking Area (HIDTA) Program. NIJ initiated the research to collect information on policies, practices, and resources available to the HIDTA program and partnering law enforcement agencies for major crime deterrence, prosecution, and other interventions specific to illegal prescription drug markets. One goal of the HIDTA program is to coordinate intelligence and information sharing and enforcement efforts across federal, state, local, and tribal law enforcement agencies involved in the investigation and prosecution of drug trafficking organizations operating within the HIDTA region, making the HIDTA program a valuable resource for collecting information on drug market interventions. Since 2008, through the Audit Service Contract, Abt Associates has worked with HIDTA programs across the country to collect information on performance measurement related to training, intelligence and information sharing, and enforcement activity. For this study, the plan was to expand the audit activities to collect information specific to strategies implemented by selected HIDTAs to disrupt the regional illegal prescription drug market through partnerships with the public health or medical communities, training, and the investigation and prosecution of drug trafficking organizations involved in trafficking illegal prescription drugs. NIJ identified the following three HIDTA regions for this study: the Northwest HIDTA region, which includes multiple counties in the state of Washington; the New Mexico HIDTA region, which includes multiple counties in the state of New Mexico, and the New England HIDTA region, which includes counties in the states of Massachusetts, Connecticut, Rhode Island, New Hampshire, Vermont, and Maine. The original research goals included identifying interventions applied by the HIDTA to address the regional illegal prescription drug market. We found, however, that we were not able to have conversations with federal law enforcement officials leading major investigations of drug trafficking organizations due to the public nature of this report. Therefore, discussion of law enforcement investigation activity is limited to information from representatives from task forces led by state or local law enforcement agencies, which limited the scope of the investigations that could be discussed. This report begins by providing background on the illegal prescription drug threat in the United States and the multiple strategies used to divert prescription drugs, and then reviews the range of responses supported by ONDCP, through the HIDTA program, and by state agencies through Prescription Drug Monitoring Programs (PDMPs). The study draws on a variety of sources that include scientific and professional literature, published materials from Federal, state, and local programs, internet searches related to enforcement, education, and prevention, as well as discussions with law enforcement and administrators from state PDMPs. This is a report of our findings. Abt Associates Research on Illegal Prescription Drug Market Interventions: