Opioids, and the addiction they can cause can be a never-ending cycle of pain, prescriptions, arrests and prosecution. It starts out innocent enough as a pain medication prescription for a broken bone, toothache, surgery or injury of any type. The patient begins to depend heavily on that medication and seeks it out from their doctor. If they can’t get it there, they might resort to the streets — even the dark route of heroin because it’s cheaper — and if they’re unable to afford the illicit prescription medication or illegal heroin, they could delve down the road of crime to fund their habit.
Opioids had a big hold on addicts long before healthcare providers and lawmakers knew what was happening, possibly due to it’s previous ready availability by prescription as well as on the street. According to the Tennessee Bureau of Investigation data, hydrocodone costs $5-$7 per pill, Percocet is $7-$10 per pill, oxycodone IR costs around $30-$40 per pill, and OxyContin tops the list at about $80 per pill. Heroin, a less-expensive option, costs around $15 per bag, the TBI data showed.
It’s logical to see how someone who spends about $300 a day on OxyContin would spend a fraction of that for heroin.
Law enforcement and prosecutors saw the problem, and the court system was inundated with people charged in opioid-related crimes, before any real action was taken to heavily regulate access to the drugs or help people kick their addiction.
“This is not just a drug problem,” said Rob Reeves, first assistant U.S. attorney for the Eastern District of Tennessee. “What we saw with some of these dealers is they were also taking stolen property (for drugs.) They would swap stolen property, guns, anything the drug dealer might be interested in for the OxyContin. It’s a very strong addiction, so they’re willing to burglarize houses, they’re willing to burglarize cars, whatever they need to do.”
Reeves said the U.S. Attorney’s Office saw a big influx of cases between 2005 and 2010 of doctor shopping crimes and pill mills.
“We started seeing the groups going down to, primarily Florida but also Georgia and some other states. They would literally take van loads of people, go down there, doctor shop at these clinics that were set up to dispense painkillers and generally there would be an organizer of the group who would sponsor them. That’s what they called it. They would each visit the doctor, they would each get the maximum prescription, then they would either come back and split that with (the organizer) or they would be paid cash for their prescription, then it would be distributed in the typical drug conspiracy type organization.”
Reeves said there was also a big increase in pharmacy robberies, and local law enforcement saw drug fraud cases start to climb.
Johnson City police know all too well about opioid distribution. Patrol officers and narcotics investigators deal with it mainly on the street dealer or user level.
“Of prescription narcotics, we are seeing primarily oxycodone and hydrocodone or a derivative of these,” Johnson City Police Chief Mark Sirois said. “These are the most prevalent. In absence of and in addition to these narcotics, there is some heroin, which has similar effects.”
Sirois said opioid abuse also leads to other crimes.
“The prevalence of drug addiction in general creates a corresponding impact on criminal activity,” Sirois said. “With drug addiction and its often life-altering effects, and the need to maintain the addiction and its escalation, many users find themselves in a situation where they will participate in criminal activity in order to maintain their addition. This is not to say that all persons addicted to drugs commit crime, but there can be a strong correlation.
“Therefore, a large percentage of crime — including those mentioned above — may be tied to drug addiction. Other crimes include domestic violence and driving under the influence. Although I don't have a specific percentage, any officer who works cases could give you any number of stories of arrestees who are in this category,” Sirois said.
Addiction has also led to numerous pharmacy robberies, but instead of demanding cash the robber demanded drugs, Reeves said.
“During this same time period, we also had a drastic increase in the pharmacy robberies we were prosecuting,” Reeves said. “They were literally going into the pharmacy, most of them were armed, and they were demanding the morphine and OxyContin. They didn’t even want the money. They just wanted the drugs. We still see that occasionally. During that time period, it was really prevalent because these people would do anything to get that next fix. It’s not that it makes them feel so good, but they don’t want to feel with that down with not being able to take it. They’re not only psychologically addicted, they’re physically addicted. If you take opiates and you quit, you get sick as well as have the psychological effect by not taking it.”
So what can law enforcement and court officials do to to combat opioids and the devastating effect they have?
For Interim U.S. Attorney Nancy Harr and Reeves, it’s taking down the dealers. In the federal court system there are no alternatives for drug traffickers except prison. There, programs are available if the offender wants to break their behavior associated with addiction.
On the local level, officials have many more options, although Sirois said the JCPD is in the business of arresting and convicting drug offenders.
“The Johnson City Police Department for years has taken a very proactive and aggressive approach to the drug problem, and drug-related crime, in our city,” Sirois said. “Our focus is drug dealers, because they are driving the cycle of addiction and crime. Our Special Investigations Squad, working narcotics cases, vigorously develops leads and follows up on tips in order prosecute dealers in our community, many of whom come from outside our community.”
Local law enforcement also works closely with state and federal investigators when necessary and takes an active role in prosecuting dealers in federal court.
“We partner with state and federal agencies to prosecute drug dealers at the federal level, many of whom are violent repeat offenders and armed career criminals,” he said. “Two of these federal programs in which we participate are the Federal Bureau of Investigation Safe Streets Task Force, and the Drug Enforcement Administration Organized Crime and Drug Enforcement Task Force. To each of these programs, we have a Johnson City investigator assigned full-time.”
JCPD also assigns an investigator to the 1st Judicial District Drug Task Force, which is comprised of officers from each of the four counties in the district.
“The 1st DTF investigates drug activity and brings prosecutions of dealers across the entire district,” Sirois said. “Additionally, the city continues to fund the department's special (federal) prosecutor program, which supports a prosecuting attorney to try qualifying cases involving drug-related and violent crime at the federal level, where sentencing is much more stringent than state level sentencing, and there is little to no "good time" for these career offenders in the federal system.”
Sirois said without the help of Harr, Reeves and District Attorney General Tony Clark and other federal and local partners “we would not be nearly as effective.”
But it isn’t just enforcement and prosecution on the local level that has proven effective, Sirois said, recalling the huge success of a Department of Justice grant, Targeted Community Crime Reduction Program.
“You can't solve most crime problems simply by enforcement, and our society is not going to arrest itself out of the opioid addiction epidemic,” he said. “It will continue to demand a holistic approach. I think you (the Johnson City Press) are well familiar with the TCCRP and its positive impact on the Mountain Home and downtown areas over the past three years. One of the abiding legacies of the TCCRP will be the Day Reporting Center, and its program to divert offenders referred by the Criminal Court from addiction and criminal behavior to becoming contributing, productive members of our community.”
The three-year TCCRP grant ran out at the end of June, but just last week, the DRC graduated 27 participants and turned over the reigns to the Tennessee Department of Correction, which has opted to pick up all funding and management for the program.
“Several have graduated from the DRC, and are moving forward with their lives. It's not all success, but it is all worth it,” Sirois said.