In addition to allowing physicians to identify potential substance abuse, New Jersey’s opioid prescription database has also become an effective tool for law enforcement, helping them track down prescribers who are improperly distributing these highly addictive drugs.
The New Jersey Prescription Monitoring Program, which includes some 73 million entries, tracks opioid prescriptions filled for many patients in the Garden State and enables physicians and pharmacists to confirm a patient’s patterns of use before dispensing the drugs, in an effort to guard against so-called ‘doctor shopping.’
The state attorney general announced last week that the New Jersey Prescription Monitoring Program had led them to arrest an Essex County physician and 17 Shore-area and South Jersey residents who worked with him to illegally distribute tens of thousands of potentially deadly pain pills in Atlantic County, more than 100 miles from the doctor’s office. The investigation is continuing, as officials said the operation might have involved other counties as well.
Dr. Craig Gialanella, whose practice is in Belleville, is the sixth doctor to be charged with illegal opioid distribution thanks to the work of the Prescription Fraud Investigation Strike Team, which was launched three years ago to examine potential “pill mills” and related crimes. The other defendants included a divorced couple, the woman’s three adult children, and a dozen other individuals, all ranging in age from 28 to 54 years old.
Hammering home the message
“We’ll continue to bring these cases and hammer home the message that these corrupt healthcare professionals are just as culpable as the heroin dealers, gang leaders, and cartel members who profit from the epidemic of opiate addiction,” said Elie Honig, director of the Division of Criminal Justice, which oversaw the “Operation Oxy Highway” probe.
Gialanella allegedly charged patients $100 or less for a brief office visit and, without performing an exam or determining medical need, would write them as many as five undated prescriptions at a time, each for hundreds of powerful opiates and anti-anxiety medicines. But when a pharmacist in Atlantic County began to see dozens of addictive prescriptions from the same Essex County physician, he called the attorney general’s office and prompted the investigation, which began in December.
A flood of ‘oxy’
According to the PMP, Gialanella wrote more than 400 prescriptions to 30 people from the Atlantic County area in 2016 alone, providing them access to some 50,000 oxycodone pills. Overall, the internist prescribed more than 350,000 “oxys” during the past four and half years, the database showed, drugs that would have fetched more than $7 million if sold on the street, officials said.
The monitoring system also appeared to reflect the impact of a new law to drastically limit first-time opioid prescriptions for many patients, which Gov. Chris Christie signed in February. The AG’s office said Gialanella started to “significantly curtail his alleged illegal prescribing of oxycodone” after the five-day cap, the nation’s most extensive limit, took effect.
New Jersey launched its PMP in 2011 and, while voluntary at first, prescribers must now check the system before they provide most patients with opioids or other addictive painkillers classified as Schedule II drugs by the federal government. The database links to systems in more than a dozen other states — including those on the borders — and was searched nearly 2.4 million times last year by physicians, pharmacists, and other healthcare providers.
Making it mandatory
Lawmakers are also seeking to make the system mandatory for emergency room doctors, who have been excluded. And last week Sen. Robert Singer (R-Ocean), who represents a district rife with opiate addiction, outlined his plans for legislation that would make it easier for police officials to access the database too. Law enforcement officials now need a subpoena or court order to log into the system.
“The NJPMP has proven to be one of the most effective tools we have to combat New Jersey’s opioid crisis. This legislation is the next logical way to maximize the use of this invaluable resource,” explained Singer, who worked on the proposal — not yet posted on the state legislature’s website — with Monmouth County Prosecutor Christopher J. Gramiccioni.
State-based databases and other regulations to reduce access to opioids have helped drive down the use of addictive prescription drugs nationwide, according to a new federal report, and data from the American Medical Association suggests use of these medicines declined 11 percent in the Garden State between 2014 and 2016. But other studies show the number of addiction diagnoses continues to climb nationwide and drug deaths — at least in New Jersey — are also on the rise.
Attorney General Christopher S. Porrino also released data last week that showed opioid-related drug deaths jumped more than 40 percent in the first half of 2016, versus the previous year. Fatalities from Fentanyl and its variants — synthetic opiates that can be many times more powerful than heroin – more than doubled from the first six months of 2015. In all, a total of 1,587 people died of drug overdoses in all of 2015, while 1,022 New Jerseyans were killed by opiates between January and July of 2016 alone.
‘No easy fix’
“There’s no easy fix to the epidemic of opiate addiction, which means we must continually re-dedicate ourselves to the hard work of fighting it on every front: through addiction prevention, including our new limits on prescription opioid painkillers; promoting treatment options in our communities; and in the criminal justice system,” Porrino said, “and of course continuing aggressive criminal enforcement targeting major heroin traffickers, as well as pill mills and corrupt healthcare providers who divert prescription opiates.”
Under “Operation Oxy Highway,” Gialanella was arrested last Monday (July 17) and charged with narcotics distribution. Prosecutors said the drug distribution ring was led by Douglas Patterson, his ex-wife Mary Connolly, and her daughter Lauren Connolly, all of Egg Harbor; Mary Connolly’s sons, Robert and Michael, of Galloway, were also charged. Prescriptions written for Patterson — which included different dates of birth in an alleged attempt to avoid PMP detection — were what first attracted attention from the Atlantic County pharmacist.