Abuse of addictive medications by Guam residents, still a lesser problem than pervasive methamphetamine and marijuana abuse on island, has peaked the interest of federal drug authorities.
“Similar to what is occurring in the rest of the U.S., prescription drug abuse and the abuse of club drugs is becoming a more significant problem on Guam,” said Timothy Massino, spokesman for the Drug Enforcement Administration.
“We are aware of the rising problem with prescription drug … abuse and we are involved in various investigations at this time,” Massino said in an email.
However, it’s still a lesser problem than pervasive methamphetamine and marijuana abuse on island
Recently, seven men were indicted in connection with thousands of pills seized from a Dededo home.
Authorities arrested Lucas Briola Rebanal who was charged with multiple drug-related crimes including possession with intent to sell prescription drugs known as Ritalin, Klonopin and Valium and unlawful possession of drugs known as Percocet, Dilaudid, Vicodin, Xanax, Ambien and Ativan, according to the indictment.
The Dededo bust was among the largest prescription drug seizures in Guam, Massino said.
Locally, pills like Klonopin, Valium and Percocet are sold for about $10 to $15 each on the street, Massino said.
Rebanal’s house was reportedly found with 2,000 pills of Ritalin, some 3,200 more pills of Klonopin, another 1,200 Valium pills and smaller amounts of oxycodone, court documents state.
The pills found in the Dededo home are considered illegal substances under Guam law.
Longtime pharmacist Thomas J. Caruso said he suspects the pills found during the Dededo raid came from a pharmacy that was burglarized last year.
Caruso has been a pharmacist for 49 years and spent the last 24 years of his career on Guam.
“I don’t think there has been an uptick in fraudulent prescriptions over the last several years,” Caruso told the Pacific Daily News in an email. “Once, or maybe twice, a year someone will try to pass a fraudulent prescription for controlled substances, they are usually pretty obvious, due to inept attempts to forge the prescriptions as well as the doctors’ names.”
Police last month arrested suspect Derick Evan Hills for alleged falsified prescription for Percocet, according to court documents. When he was arrested on Valentine’s Day, Hills was also on probation for another criminal case involving identical conduct, documents state.
A fraudulent prescription is the most common way someone might try to get the drugs, Massino said.
Because the island is small and there are only so many doctors and pharmacies that dispense controlled substances on island, Caruso said it’s more difficult to try and pass off a fake prescription.
The pharmacists and pharmacy technicians here recognize the doctors’ signatures, Caruso said. The pharmacy can call a doctor’s office to verify a prescription and if the doctor cannot be reached, sometimes the customer must wait or fill their prescription at another pharmacy, according to Caruso.
“A pharmacist is well within his or her rights to refuse to fill a prescription if they find it suspicious for any reason,” he said.
“If a prescription is obviously forged, then a call to the police hotline is in order and that will nip it in the bud, so to speak,” he said.
Pharmacists also can access a local database that allows them to look into a customer’s prescription history and where they have had their prescriptions filled, Caruso said.
The Guam Prescription Drug Monitoring Program was implemented in 2013, according to Jeffrey Pinaula, program coordinator for the Department of Public Health and Social Services. The public health department oversees the program.
Pinaula said law enforcement officials can request access to a patient’s, prescriber’s or dispenser’s information if needed for an investigation. Since 2013, there’s only been one request from law enforcement to access the database.
The database helps prevent against “doctor shopping,” which are cases when a patient might go to more than one doctor for prescriptions and then go to more than one pharmacy to have them filled, Caruso said.
Before the prescription drug monitoring program, it was up to the individual pharmacists to verify with other pharmacies about a customer’s prescription for controlled substances, according to Caruso.
Meth, marijuana bigger problems
Comparatively, the local problem with addictive prescription drugs is not as large a problem as the widespread abuse of methamphetamine and marijuana, DEA’s Massino said.
The federal drug department publishes an annual National Drug Threat Assessment, and the listed “drugs of choice” for Guam are methamphetamine and marijuana.
Even so, the DEA is monitoring the prescription drug use and abuse on island.
“The prescription drug epidemic cuts across every demographic, but currently there seems to be a trend on Guam where college students and people in their 20s and 30s are misusing prescription medications,” Massino said.
Abuse is more common than most would believe, Caruso said.
“Family members or friends may ‘borrow’ or steal prescription medications from unsuspecting patients. There may also be those who get prescriptions for controlled substances and then just sell the medications outright,” Caruso said.
Sometimes abuse could start with a legitimate prescription, according to Caruso.
“My feeling is that prescription drug abuse of controlled substances usually starts with an injury that a doctor treats with narcotic pain relievers,” he said.
“If the injury is not self limiting and continues for an extended period of time, there’s a good chance that the patient will become habituated to or addicted to narcotic pain relievers.”
Over time, the doses of medication will increase until it’s almost impossible for the patient to stop taking the medication, Caruso said.
Caruso also said doctors should be wary of patients who ask for narcotics right away, and patients should be informed about short- and long-term effects of the medicine they’re consuming.
Caruso added that education will go a long way in preventing future abuse.
“Personally, I find that customer and patient counseling is the most effective way to both help customers and to stop prescription drug abuse. Also, a constant educational campaign by the local government would be of great help,” he said.