On May 20, 2015, DEA issued a press release regarding a recent major enforcement action in Arkansas, Alabama, Louisiana, and Mississippi. Operation Pilluted targeted alleged pill mills that were engaged in the illegal distribution of oxycodone, hydrocodone and Xanax. The operation resulted in the arrest of 280 individuals, including 22 doctors and pharmacists. Executing 21 search warrants and 71 seizure warrants, law enforcement seized 51 vehicles, 202 weapons, more than $12 million and nearly $7 million in real property. DEA obtained the voluntary surrender of 40 DEA registrations and issued two Orders to Show Cause and Immediate Suspension of Registration. Enforcement actions aimed at the physicians who issue prescriptions without a legitimate medical purpose stops prescription drug diversion at the source and we applaud DEA for focusing its efforts on those physicians and other individuals involved in prescription drug trafficking.
Large operations, such an Operation Pilluted, have a ripple effect on the legitimate prescribing and distribution of controlled substances. Pharmacies that fill illegitimate prescriptions often fill many legitimate prescriptions as well. When they are shuttered, the demand – legitimate and otherwise – will shift elsewhere. Legitimate patients will continue to need access to their medications even if their physician no longer has a DEA registration. Likewise, drug abusers will continue to seek access to narcotics. Demand for controlled substances will shift to other retail pharmacies as a result of these closures (the balloon effect), requiring pharmacies and distributors to remain vigilant and closely scrutinize prescriptions and orders for controlled substances. We have observed and written about the unintended consequences that often accompany large enforcement operations, namely restricting access to prescriptions controlled substances for legitimate patients. This is an issue that the supply chain, pharmacists, DEA and other government agencies must work together to avoid in the wake of large enforcement operations. Pharmacies and distributors should ensure that any identified “red flags” are adequately resolved. Close coordination with regulators, where practicable, is a prudent measure to ensure that legitimate patient needs continue to be met.