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Log onto the Center for Problem-Oriented Policing website 
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Problem-Oriented Guides for Police 
Problem-Specific Guides Series 
Guide No. 24 

Prescription Fraud 

Julie Wartell 
Nancy G. La Vigne 

This project was supported by cooperative agreement 
#2002CKWX0003 by the Office of Community Oriented Policing 
Services, U.S. Department of Justice. The opinions contained herein 
are those of the author(s) and do not necessarily represent the official 
position of the U.S. Department of Justice. 

www.cops.usdoj.gov 

ISBN: 1-932582-33-9 

May 2004 


About the Problem-Specific Guides Series 

The Response Guides are one of three series of the Problem-
Oriented Guides for Police. The other two are the Problem-
Specific Guides and Problem-Solving Tools. 

The Problem-Oriented Guides for Police summarize knowledge 
about how police can reduce the harm caused by specific 
crime and disorder problems. They are guides to preventing 
problems and improving overall incident response, not 
to investigating offenses or handling specific incidents. 
Neither do they cover all of the technical details about how 
to implement specific responses. The guides are written 
for policeof whatever rank or assignmentwho must 
address the specific problems the guides cover. The guides 
will be most useful to officers who: 

 understand basic problem-oriented policing principles and 
methods 
 can look at problems in depth 
 are willing to consider new ways of doing police business 
 understand the value and the limits of research knowledge 
 are willing to work with other community agencies to find 
effective solutions to problems. 

The Response Guides summarize knowledge about whether 
police should use certain responses to address various 
crime and disorder problems, and about what effects they 
might expect. Each guide: 

 describes the response 
 discusses the various ways police might apply the response 
 explains how the response is designed to reduce crime and 
disorder 
 examines the research knowledge about the response 


 addresses potential criticisms and negative consequences 
that might flow from use of the response 
 describes how police have applied the response to specific 
crime and disorder problems, and with what effect. 

The Response Guides are intended to be used differently 
from the Problem-Specific Guides. Ideally, police should 
begin all strategic decision-making by first analyzing the 
specific crime and disorder problems they are confronting, 
and then using the analysis results to devise particular 
responses. But certain responses are so commonly 
considered and have such potential to help address a range 
of specific crime and disorder problems that it makes 
sense for police to learn more about what results they 
might expect from them. 

Readers are cautioned that the Response Guides are designed 
to supplement problem analysis, not to replace it. Police 
should analyze all crime and disorder problems in their 
local context before implementing responses. Even if 
research knowledge suggests that a particular response 
has proved effective elsewhere, that does not mean the 
response will be effective everywhere. Local factors matter 
a lot in choosing which responses to use. 

Research and practice have further demonstrated that, 
in most cases, the most effective overall approach to 
a problem is one that incorporates several different 
responses. So a single response guide is unlikely to provide 
you with sufficient information on which to base a 
coherent plan for addressing crime and disorder problems. 
Some combinations of responses work better than others. 
Thus, how effective a particular response is depends 
partly on what other responses police use to address the 
problem. 


These guides emphasize effectiveness and fairness as 
the main considerations police should take into account 
in choosing responses, but recognize that they are not 
the only considerations. Police use particular responses 
for reasons other than, or in addition to, whether or not 
they will work, and whether or not they are deemed fair. 
Community attitudes and values, and the personalities 
of key decision-makers, sometimes mandate different 
approaches to addressing crime and disorder problems. 
Some communities and individuals prefer enforcement-
oriented responses, whereas others prefer collaborative, 
community-oriented, or harm-reduction approaches. These 
guides will not necessarily alter those preferences, but are 
intended to better inform them. 

The COPS Office defines community policing as 
a policing philosophy that promotes and supports 
organizational strategies to address the causes and reduce 
the fear of crime and social disorder through problem-
solving tactics and police-community partnerships. 
These guides emphasize problem-solving and police-community 
partnerships in the context of addressing specific public 
safety problems. For the most part, the organizational 
strategies that can facilitate problem-solving and police-
community partnerships vary considerably and discussion 
of them is beyond the scope of these guides. 

These guides have drawn on research findings and police 
practices in the United States, the United Kingdom, 
Canada, Australia, New Zealand, the Netherlands, and 
Scandinavia. Even though laws, customs and police 
practices vary from country to country, it is apparent that 
the police everywhere experience common problems. In 
a world that is becoming increasingly interconnected, it is 
important that police be aware of research and successful 
practices beyond the borders of their own countries. 


Each guide is informed by a thorough review of the 
research literature and reported police practice and is 
anonymously peer-reviewed by line police officers, police 
executives and researchers prior to publication. 

The COPS Office and the authors encourage you to 
provide feedback on this guide and to report on your 
own agencys experiences dealing with a similar problem. 
Your agency may have effectively addressed a problem 
using responses not considered in these guides and your 
experiences and knowledge could benefit others. This 
information will be used to update the guides. If you wish 
to provide feedback and share your experiences it should 
be sent via e-mail to cops_pubs@usdoj.gov 

For more information about problem-oriented policing, 
visit the Center for Problem-Oriented Policing online at 
www.popcenter.org. This website offers free online access 
to: 

 the Problem-Specific Guides series 
 the companion Response Guides and Problem-Solving Tools 
series 
 instructional information about problem-oriented policing 
and related topics 
 an interactive problem-oriented policing training exercise 
 an interactive Problem Analysis Module 
 a manual for crime analysts 
 online access to important police research and practices 
 information about problem-oriented policing conferences 
and award programs. 


Acknowledgments 

The Problem-Oriented Guides for Police are produced by the 
Center for Problem-Oriented Policing, whose officers are 
Michael S. Scott (Director), Ronald V. Clarke (Associate 
Director) and Graeme R. Newman (Associate Director). 
While each guide has a primary author, other project 
team members, COPS Office staff and anonymous peer 
reviewers contributed to each guide by proposing text, 
recommending research and offering suggestions on 
matters of format and style. 

The project team that developed the guide series 
comprised Herman Goldstein (University of Wisconsin 
Law School), Ronald V. Clarke (Rutgers University), 
John E. Eck (University of Cincinnati), Michael S. Scott 
(University of Wisconsin Law School), Rana Sampson 
(Police Consultant), and Deborah Lamm Weisel (North 
Carolina State University.) 

Members of the San Diego; National City, California; and 
Savannah, Georgia police departments provided feedback 
on the guides format and style in the early stages of the 
project. 

Cynthia E. Pappas oversaw the project for the COPS 
Office. Research for the guide was conducted at the 
Criminal Justice Library at Rutgers University under the 
direction of Phyllis Schultze. Suzanne Fregly edited this 
guide. 


Contents 

About the Problem-Specific Guides Series ................i

Acknowledgments ....................v

The Problem of Prescription Fraud ............1
Related Problems .............3
Factors Contributing to Prescription Fraud .............3
Abuse of and Addiction to Prescription Drugs ...........4
Types of Prescription Drugs Abused .............4
Types of Offenders ...................6
Types of Fraud ...........8
Understanding Your Local Problem ............13
Asking the Right Questions ...............13
Victims ................13
Offenders .......................13
Locations/Times ..................14
Capturing and Analyzing Data ..........15
Measuring Your Effectiveness ...............15
Responses to the Problem of Prescription Fraud ..............17
General Requirements for an Effective Strategy .............18
Specific Responses to Prescription Fraud ..............21
Increasing the Risk of Detection ........21
Increasing the Effort Required to Commit Prescription Fraud ..... 24
Reducing Rewards to Offenders .......30
Removing Excuses .................30
Responses With Limited Effectiveness ............31

Appendix:Summaryof Responses to Prescription Fraud ...33

Endnotes ......................37

References ....................39 
About the Authors.............45 
RecommendedReadings ..............47 
Other Problem-Oriented Guides for Police .........51 


The Problem of Prescription Fraud 

This guide describes the problem of prescription fraud,  
and reviews the factors that increase the risks of it. It  
then identifies a series of questions to help you analyze  
your local problem. Finally, it reviews responses to the 
problem, and what is known about them from evaluative 
research and police practice. 

For the purposes of this guide, prescription fraud, which 
falls under the broader heading of "pharmaceutical 
diversion," is defined as the illegal acquisition of 
prescription drugs for personal use or profit. This 
definition excludes theft, burglary, backdoor pharmacies, 
and illegal importation or distribution of prescription 
drugs. 

 "Backdoor pharmacies" are
businesses not licensed/authorized
to distribute pharmaceutical drugs.

Prescription fraud is a significant and growing problem. 
Almost half the law enforcement agencies responding to 
a 2000 National Drug Threat Survey listed pharmaceutical 
abuse as a problem in their jurisdiction, and a similar share 
reported observing dramatic increases in prescription 
fraud and pharmaceutical drug abuse.1 

While prescription fraud is common throughout the 
country, its intensity varies from place to place. This is 
often due to trends in specific types of drugs popular 
in different regions. It is a serious form of illegal drug 
activity, rivaling that involving more traditional street 
drugs, such as heroin and cocaine. Nationwide in 1993, 
people spent an estimated $25 billion on prescription 
drugs in the illegal market, compared with $31 billion 
on cocaine, including crack.2 Put another way, a recent 
study concluded that the number of people who 
abuse prescription drugs each year roughly equals the 



number who abuse cocaineabout 2 to 4 percent of the 
population.3 The local scope of the problem is similar. 
For example, the state of Kentucky estimates that over 
half the drug cases investigated through a federal law 
enforcement initiative involved prescription drugs.4 The 
Cincinnati Police Department's Pharmaceutical Diversion 
Squad reported that, in 9 years, more than 2 million doses 
of prescription drugs had been diverted illegally in the 
city.5 

People commit prescription fraud in numerous ways, 
including forging prescriptions, going to several doctors 
to get multiple prescriptions (termed "doctor shopping"), 
and altering prescriptions to increase the quantity. 
However, the true scope of prescription fraud is largely 
unknown, due to a number of factors. Successful 
offenders get caught less often, and police never detect 
most of their offensesas with any crime. Unlike other 
crimes, however, much prescription fraud goes undetected 
because it is not a high police priority; very few local 
agencies systematically track it. Limited awareness and 
lack of oversight among doctors and pharmacists may 
also contribute to the problem. In addition, because 
those who commit prescription fraud usually pay for the 
prescriptions (either personally or through insurance), 
pharmacies are less likely to perceive themselves as 
victims, to view prescription fraud as a crime, and to 
report fraud. Despite these difficulties in determining 
the scope of the problem, it stands to reason that, as the 
legitimate prescription drug market increases, prescription 
fraud will, as well. 

 The National Association of 
Chain Drug Stores projected that, 
in 2002, the industry would yield 
$188.5 billion in sales: 40 percent 
from traditional chain drug stores, 
20 percent from independent 
stores, 17.9 percent from mail 
orders, 12.5 percent from grocery 
store pharmacies, and 9.7 percent 
from mass merchants (National 
Association of Chain Drug Stores 
2002). 


Related Problems 

Offenders obtain prescription drugs in various ways, often 
to make a profit. Related problems that require their own 
analyses and responses include the following: 

 
Medicaid fraud. Pharmacy workers sometimes 
commit Medicaid fraud, usually by substituting generic 
drugs for name brands, short counting pills, and 
filling prescriptions without a refill, then over-billing 
Medicaid. They may also bill Medicaid for drugs they 
never dispensed.6 
 
Online ordering. Many people try to obtain 
prescription drugs illegally through the Internet. While 
most websites require proof of prescriptions, people 
can easily fabricate them, and vendors do not routinely 
verify them. 
 
Theft. Pharmacy workers and healthcare providers, 
both of whom have easy access to prescription drugs, 
sometimes steal them. 
 
Burglary and robbery. Offenders obtain prescription 
drugs by either burglarizing or robbing pharmacies. 

Factors Contributing to Prescription Fraud 

Understanding the factors that contribute to prescription 
fraud will help you frame your own local analysis 
questions, determine good effectiveness measures, 
recognize key intervention points, and select appropriate 
responses. 

 See the POP Guide on Burglary of 
Retail Establishments. 


Abuse of and Addiction to Prescription Drugs 

The biggest factor driving prescription fraud is the 
increasing abuse of and addiction to prescription drugs. 
Prescription drug abuse is significant and rising rapidly. In 
2000, an estimated 2 million Americans over the age of 12 
used prescription pain relievers for the first time, up from 
400,000 in the mid-1980s.7 In 2001, an estimated 11.1 
million people used prescription drugs non-medically, and 
more than 6 million abused pain relievers.8 

This increase is reflected in overdose cases. Visits to 
emergency rooms increased significantly from 1994 
to 2001 for overdoses on narcotic prescription pain 
relievers.9 "Other substances of abuse," which are usually 
those marketed legally as prescription or over-the-counter 
drugs, represented 43 percent of emergency room drug 
mentions in 2001.10 Law enforcement officials have 
witnessed similar trends, estimating that, of the 20 most 
commonly abused drugs, over half are obtainable by 
prescription.11 

Types of Prescription Drugs Abused 

The prescription drugs that law enforcement agencies 
most frequently listed as commonly abused include Valium 
(diazepam) and Vicodin (hydrocodone), as well as Xanax 
(alprazolam), OxyContin (oxycodone), Lorcet, Dilaudid, 
Percocet, Soma, Darvocet, and morphine.12 Many of these 
top the lists of prescription drugs used nonmedically by 
youths and young adults, who tend to favor pain relievers 
such as codeine, methadone, Demerol (meperidine), 
Percocet, Vicodin, and OxyContin.13 


Many experts attribute the growth in prescription drug 
abuse in part to the recent availability of OxyContin, 
an oral, controlled-release form of oxycodone that acts 
for 12 hours.14 As prescribed by a doctor, OxyContin 
is a very effective pain reliever. However, when crushed 
and snorted or mixed with water and injected, the drug 
delivers all of its power in one punch, producing a high 
similar to that experienced with heroin.15 Thus, heroin 
addicts favor OxyContin, but it has also taken hold among 
the general population. 

Illegal use of OxyContin has spread throughout many 
regions of the United States, and has significantly 
impacted the volume of prescription fraud and related 
problems nationwide. For example, nearly 85 percent of 
1999 arrests for writing false prescriptions in Maryland 
involved oxycodone products, including OxyContin.16 
In Florida, lab submissions indicated that police are 
increasingly seizing oxycodone: between 1995 and 2000, 
oxycodone lab submissions increased by 161 percent. 
OxyContin has taken hold both because it can be addictive 
and because it commands high dollars on the black 
market, with a street value of as much as $80 per 80 milligram dose.17 

Hydrocodone, the third most prescribed drug in 2000, is 
among the most abused of prescription drugs, according 
to the National Clearinghouse for Alcohol and Drug 
Information.18 It is similar to oxycodone but is less 
potent, with less potential for abuse.19 In certain regions, 
Vicodin, a form of hydrocodone, is becoming a popular 
target for prescription fraud, usually among women who 
become addicted after originally being prescribed the drug 
for pain relief.20 


Types of Offenders 

Unlike perpetrators of other drug-related crimes, 
prescription fraud offenders span a wide range of ethnic, 
social, educational, and economic backgrounds. Often, 
they become addicted to drugs legally prescribed to them, 
then try to get additional drugs illegally. Other offenders, 
already addicted to street drugs, discover how to convert 
prescription drugs into more potent substances. Among 
youth, abuse of prescription drugs is often a gateway to 
use and abuse of illegal drugs, such as marijuana. The 
elderly and healthcare workers are also susceptible to 
prescription drug addiction and fraud. 

Youth. The most dramatic increases in illegal prescription 
drug use in recent years have been among youth. Of the 
estimated 11.1 million people using prescription drugs 
non-medically in 1999, nearly half (5.4 million) were aged 
12 to 25.21 Non-medical prescription drug use is often 
accompanied by other illicit drug use: one study found 
that 63 percent of 12-to 25-year-olds who had used 
prescription drugs non-medically in the past year had also 
used marijuana in the past year.22 Non-medical use of a 
prescription drug found in the home can quickly lead to 
burglary, theft, and drug sales. For example, in 2001, a 
14-year-old Florida boy died of an OxyContin overdose 
the day after he and a friend stole about 50 pills during 
a residential burglary.23 Likewise, a number of police 
agencies have reported incidents of schoolchildren's 
selling prescription drugs, particularly Ritalin, to 
classmates.24 Research shows that non-medical use of 
prescription drugs (mostly pain relievers such as Percodan 
and Vicodin) among youth is rising.25 


Women. Women may be more likely than men to commit 
prescription fraud, as they are 48 percent more likely to be 
prescribed an abusable (i.e., narcotic or antianxiety) drug.26 
While overall, men and women have roughly similar rates 
of non-medical prescription drug use, research has shown 
that among women and men who use a sedative, antianxiety 
drug, or hypnotic, women are almost twice as likely to 
become addicted.27 In San Diego, the typical prescription 
fraud offender is a middle-class woman, who often 
becomes addicted after being prescribed a pain reliever for 
a legitimate health problem.28 

Older adults. Older adults are more susceptible to 
prescription drug abuse because they use such drugs at 
a rate three times that of the general population, and 
also often have trouble following their doctor's dosage 
instructions.29 Given the high rate of prescription drug 
misuse among the elderly, it is possible that addiction 
is common as well, which could ultimately lead to 
prescription fraud. 

Existing addicts. Several police agencies have observed 
increases in prescription drug abuse among heroin 
addicts and users of other illegal drugs. Users often take 
prescription drugs to ease the effects of those other 
drugs.30 Conversely, some experts have observed that those 
who become addicted to OxyContin and lose their health 
insurance often turn to heroin for a similar, and cheaper, 
high.31 


Healthcare workers. Healthcare workers are in a unique 
position to acquire and abuse prescription drugs. While 
many offenders steal drugs while working, others steal 
prescription pads or write illegal prescriptions for friends. 
Of the 250 felony arrests made by the Cincinnati Police 
Department's Drug Diversion Unit in 1999, almost a third 
involved healthcare workers, including doctors, nurses, and 
hospital workers.32 

Types of Fraud 

Prescription fraud can take many forms. The most 
common tactics are to forge or alter a prescription, to 
"doctor shop," and to phone in fraudulent prescriptions 
posing as an employee of a doctor's office. Theft of 
prescription pads is also common. 

Forging prescriptions. Forging prescription slips 
has become easier as the cost of high-quality copying 
equipment has dropped. Some offenders even go so far 
as to paint glue on the top edge of the slip to give the 
appearance that it was ripped from a pad. 

Altering prescriptions. The first resort of many users 
of legally prescribed drugs who become addicted is to 
alter a legitimate prescription to change the type of drug, 
increase the number of refills, increase the quantity, or 
add drugs (see examples below). Another tactic is to copy 
legitimate prescriptions for multiple uses.33 


Image of altered prescription
Prescription altered to change the type of drug from Tylenol II to Tylenol IV 

Image of altered prescription
Prescription altered to change the number of refills from one to four 

Image of altered prescription
Prescription altered to change the quantity from 12 to 120 

Image of altered prescription
Prescription altered to add a drug (Alprazolam) 


Doctor shopping. Those who doctor shop often go to 
multiple doctors, emergency rooms, and pharmacies and 
feign symptoms or gain sympathy to obtain prescriptions. 
Common feigned ailments include migraine headaches, 
toothaches, cancer, psychiatric disorders, and attention 
deficit disorder.34 In addition, offenders may deliberately 
injure themselves to get a prescription from an emergency 
room. Another approach is to claim to be from out of 
town and to have forgotten to pack prescription drugs,35 
or to claim to have lost the drugs from a legitimate 
prescription.36 Given recent statistics on the number of 
prescriptions doctors write, doctor shopping may be the 
prescription fraud tactic with the highest success rate: 
the Centers for Disease Control and Prevention reports 
that the number of written prescriptions per office visit 
increased by 34 percent between 1985 and 2000.37 

Calling in prescriptions. Prescription fraud in the 
form of impersonating medical staff and calling in false 
prescriptions poses the greatest challenge with regard 
to identifying suspects. Typically, offenders call in a 
prescription when the doctor's office is closed, in case the 
pharmacist calls the office to confirm that the prescription 
is legitimate; some offenders leave their own phone 
numbers for verification. Offenders are often patients or 
employees of the doctor they are impersonating, and tend 
to act overly friendly on the phone to give the impression 
that they regularly call in prescriptions. 

Stealing blank prescription forms. Some offenders 
steal prescription pads from doctor's offices and write 
prescriptions for either themselves or fictitious patients. 
They may change the phone number so that they or an 
accomplice can answer verification calls.38 

 Doctor's offices include 
physician's, veterinarian's, and 
dentist's offices. 


Understanding Your Local Problem 

The information provided above is only a generalized 
description of prescription fraud. You must combine the 
basic facts with a more specific understanding of your 
local problem. Analyzing the local problem carefully will 
help you design a more effective response strategy. 

Asking the Right Questions 

The following are some critical questions you should ask 
in analyzing your particular problem of prescription fraud, 
even if the answers are not always readily available. Your 
answers to these and other questions will help you choose 
the most appropriate set of responses later on. 

Victims 

 Whom does prescription fraud directly victimize? 
Pharmacists (who are duped into dispensing drugs not 
legitimately prescribed)? Doctors (who unknowingly 
prescribe to doctor shoppers, whose prescription 
pads are stolen, or whose names are used for 
prescription call-ins or forgeries)? Insurance companies 
and Medicaid (who sometimes pay for fraudulent 
prescriptions)? 

 Whom does prescription fraud indirectly affect (those 
who commit the fraud and are addicted, and/or their 
loved ones)? 

Offenders 

 What are the offenders' characteristics (e.g., age, gender, 
profession)? 


 
Where do they live, go to school, or work? How do 
those locations correspond to fraud locations (e.g., are 
some pharmacies or doctor's offices more likely targets 
than others)? 
 
What is the pattern of offending? Is the fraud 
intermittent or regular? Is there a regular time span 
between fraudulent acts (e.g., based on how long it 
takes to exhaust a supply of drugs)? 
 
What are the offenders' motives? Are they addicted 
to prescription drugs? Selling the drugs on the black 
market? Both? (You can interview offenders to collect 
this information. Undercover investigations, buys, and 
surveillance can reveal more about their practices). 
 
Do offenders act alone or as part of a group? 
 
What are their preferred tactics? 

Locations/Times 

 
Where does prescription fraud occur? To detect 
patterns, you should conduct location analyses based 
on the tactic used (e.g., doctor shopping patterns will 
spatially differ from prescription call-in patterns). 
Location analyses can also help you determine which 
targets are most vulnerable. For example, fraud in 
specific areas may indicate where offenders live or 
work. 
 
At what specific locations is fraud most common? Are 
certain doctors or pharmacies less likely to detect and 
report fraud? Are certain types of pharmacies (e.g., 
"mom and pop" stores, versus chain stores) more 
susceptible to fraud? 


 
What specific types of prescription drugs are diverted 
in your community or region? It is important to note 
that the prescription fraud problem and types of drugs 
diverted can vary greatly from region to region. 
 
When does prescription fraud occur (i.e., when do 
offenders try to have prescriptions filled)? Time of 
day? Day of week? As with location analyses, temporal 
analyses should be tactic-specific. Those who phone 
in prescriptions, for example, are more likely to do so 
during doctors' off hours, when pharmacies cannot 
verify the prescriptions. 

Capturing and Analyzing Data 

Prescription fraud poses a unique challenge to local police 
because it is not typically captured in computer-aided 
dispatch or records management systems. Departments 
that have succeeded in measuring and analyzing 
prescription fraud in their jurisdictions have done so 
by creating a separate database for prescription fraud 
and other pharmaceutical diversion incidents. When 
considering creating a database, your agency should 
examine the questions above, and decide how to track 
each incident to best answer the most possible questions. 

Measuring Your Effectiveness 

Measurement allows you to determine to what degree 
your efforts have succeeded, and suggests how you 
might modify your responses if they are not producing 
the intended results. You should take measures of your 
problem before you implement responses, to determine 
how serious the problem is, and after you implement 
them, to determine whether they have been effective. 


All measures should be taken in both the target area and 
the surrounding area. (For more detailed guidance on 
measuring effectiveness, see the companion guide to this 
series, Assessing Responses to Problems: An Introductory Guide 
for Police Problem-Solvers.) 

The following are potentially useful measures of the 
effectiveness of responses to prescription fraud: 

 
reduced number of reported prescription fraud cases 
 
changes in arrest patterns for drug possession and sales 
in your and neighboring jurisdictions 
 
changes in types of prescription fraud (e.g., if you 
curtail phone-ins, offenders might change tactics) 
 
changes in locations of prescription fraud 
 
changes in types of drugs obtained through 
prescription fraud 
 
reduced number of prescriptions filled for certain 
target drugs, such as OxyContin. 

It is important to remember that some of these measures 
may be misleading, depending on the types of responses 
your department applies to the problem. For example, if 
you launch a public education campaign for pharmacists 
and doctors, you may find that the amount of prescription 
fraudas measured by crimes reported to the police 
increases. 


Responses to the Problem of Prescription Fraud 

Your analysis of your local prescription fraud problem 
should give you a better understanding of the factors 
contributing to it. Once you have analyzed your local 
problem and established a baseline for measuring 
effectiveness, you should consider possible responses to 
address the problem. 

The following response strategies provide a foundation 
of ideas for addressing your particular prescription fraud 
problem. These strategies are drawn from a variety of 
research studies and police reports. Several of these 
strategies may apply to your community's problem. It is 
critical that you tailor responses to local circumstances, 
and that you can justify each response based on reliable 
analysis. In most cases, an effective strategy will 
involve implementing several different responses. Law 
enforcement responses alone are seldom effective in 
reducing or solving the problem. Do not limit yourself to 
considering what police can do: give careful consideration 
to who else in your community shares responsibility for 
the problem and can help police better respond to it. 

Unfortunately, information regarding the strategies' 
effectiveness is severely limited, because few of the 
strategies have been evaluated. The government has 
provided limited funding to police to reduce prescription 
fraud, and virtually no funding to evaluate task force and 
state and local police efforts around the country. There 
has been some government funding for state prescription 
monitoring programs and general awareness campaigns, 
but these efforts also have been minimally evaluated. 



General Requirements for an Effective Strategy 

Because the prescription fraud problem crosses several 
disciplines, addressing it must be a coordinated effort at 
all stages. The following stakeholders are among the most 
critical in controlling prescription fraud. 

 Stakeholders should be aware of 
the Health Insurance Portability and 
Accountability Act (HIPAA) regarding 
privacy and data-sharing (see www.hhs. 
gov/ocr/privacysummary.pdf). 

 
Law enforcement. The Drug Enforcement 
Administration (DEA) has created the Office of 
Diversion Control as a "central source for national 
policy guidance, support, and intelligence information 
collection and sharing" regarding pharmaceutical 
diversion issues. Many states and local jurisdictions have 
specialized personnel, units, or task forces to implement 
prescription fraud prevention strategies. There is a 
need for specialized training on controlled and non-
controlled substances and the drug scheduling system 
pharmacists use, state criminal laws and pharmacy 
regulations, types of forged and altered prescriptions, 
typical scams, and prescription fraud prevention 
techniques. Police should also educate prescribers about 
the various prescription fraud tactics and extent of the 
local problem. 

 
Healthcare providers. In general, healthcare providers 
should prescribe medication only when necessary, 
identify abuse and addiction, and provide resources 
to help patients handle addiction problems. They also 
should report all thefts of prescription pads to police 
and local pharmacies. The DEA (1999) has created an 
information brochure for healthcare practitioners that 
gives specific guidance and outlines their responsibilities 
regarding prescription drug abuse and diversion. 


 
Pharmacists. In an information brochure for 
pharmacists, the DEA (2000b) recommends using 
common sense, sound professional practice, and proper 
dispensing procedures and controls (see box below). 
Pharmacists should provide clear information to users 
about how to take the drug, be able to recognize 
fraudulent prescriptions, inform police about problem 
people and prescriptions, and follow through with 
investigations and court proceedings. Others have also 
created guidelines to help pharmacists recognize abuse 
and fraud.39 

Fraudulent Prescription Prevention Techniques 

1. Know the prescriber and his or her signature. 
2. Know the prescriber's DEA number. 
3. Know the patient (or get a profile if you do not). 
4. Check the date on the prescription. Has it been presented within 
a reasonable time? 
5. Telephone the prescriber for verification or clarification if you 
have any questions. The patient should give a plausible reason for 
any discrepancy before you dispense the drug. 
6. If you are in doubt, request proper identification. Doing so 
increases offenders' risk of getting caught. 
7. If you believe a prescription is forged or altered, do not dispense 
itcall the local police. 
8. If you believe that you have discovered a pattern of prescription 
abuses, contact the state pharmacy board or the DEA. 

Source: U.S. Drug Enforcement Administration (2000b). 



In addition to the above, other key stakeholders are 
pharmaceutical companies and a variety of state and 
federal government agencies, such as health and medical 
boards and the Food and Drug Administration (FDA), 
which controls drug scheduling. A few of the larger 
pharmaceutical companies have recently worked with 
police to curtail prescription fraud, but most importantly, 
they need to continue to educate people about taking 
drugs safely under a doctor's care. 

 For example, Purdue (the maker of 
OxyContin) has sponsored meetings 
with DEA and FDA officials, hired 
police officers to educate company 
personnel and serve as liaisons, and 
analyzed demographic data about 
geographic areas of abuse to help 
predict where the next problem will 
be and focus their efforts accordingly. 
Through informational forums, 
Abbott Laboratories (the maker of 
Vicodin) instructs prescribers and 
pharmacists about the potential for 
Vicodin abuse. 

States are responsible for creating laws that govern 
the prescribing and dispensing of prescription drugs, 
licensing drug prescribers, and investigating complaints 
and imposing sanctions for violations of state medical 
practice laws. States also regulate pharmacy practice and 
license pharmacists and pharmacies, ensure compliance 
with state and federal laws, and require the maintenance 
of prescription records. 

In 1991, the National Institutes of Health's National 
Institute on Drug Abuse (NIDA) sponsored a technical 
review and meetings on the impact of prescription 
drug diversion-control systems on medical practice and 
patient care. In 2001, a public information campaign was 
conducted regarding prescription drug misuse and abuse, 
and federal funding was made available for research. 

 Neither the 1991 evaluation nor 
the 2001 funding was directly related 
to the responses discussed in this 
guide.

Effective prescription fraud responses must be well 
coordinated among the various stakeholders, and based on 
a thorough understanding of your local problem. Police 
cannot change the fact that people will abuse and become 
addicted to prescription drugs, but they can use various 
strategies, in concert with other stakeholders, to reduce 
and prevent prescription fraud in their jurisdiction. 


Specific Responses to Prescription Fraud 

Some responses to prescription fraud fall under the 
category of "situational crime prevention." Such 
prevention (1) is directed at highly specific forms of 
crime; (2) involves managing, designing, or manipulating 
the immediate environment in as systematic and long-term 
a way as possible; and (3) makes crime more difficult and 
risky, or less rewarding and excusable, as judged by a wide 
range of offenders.40 

Increasing the Risk of Detection 

1. Informing doctors and pharmacists of fraudulent 
activity. One strategy that many police agencies, task 
forces, and pharmacy associations deem effective is 
to share information on prescription fraud scams and 
offenders through bulletins and mass communication. If 
prospective scam targets (e.g., the emergency room doctor 
who is about to be the third person in one day to see John 
Doe about his bad back, or the pharmacist who does not 
know about the stolen prescription pad) are informed, the 
offender's risk of being detected greatly increases. 

Jurisdictions such as Albuquerque (New Mexico), San 
Diego, and Tarrant County (Texas), use FaxAlert to 
notify doctors, pharmacies, and medical clinics of drug 
diversion-related activity. Each month, the Tarrant County 
Medical Society also distributes a health-scam report. 
The state of Colorado and Johnson County (Kansas) use 
a PharmAlert hotline for notification, while Abington 
(Pennsylvania) police hand out fliers describing the scam 
and containing a photo of the suspect or fraudulent 
prescription. After implementing this strategy in 1991, 
Abington saw arrests increase from one per year to one to 
two per month. 



In addition to notifying practitioners and pharmacists 
about specific prescription scams, police should also 
inform and update them on the methods and profiles of 
offenders in their jurisdiction. 

2. 
Improving pharmacists' screening of prescriptions 
and patients. Pharmacists are the "gatekeepers" or last 
lines of defense against prescription fraud. They should 
regularly check patients' identification, verify doctors' 
information, and use their experience and knowledge 
to judge when a patient's behavior is suspicious or a 
prescription is fraudulent. [Pharmaceutical Diversion 
Education offers fraud-detection training for pharmacists 
(and police). For information, visit their web site at 
www.rxdiversion.com.] 

3. 
Educating the public about prescription abuse 
and fraud. Several large-scale efforts have been made to 
educate the public about prescription abuse and fraud. 
Although these have not been police efforts, making the 
public aware that abuse and addiction are the underlying 
cause of much prescription fraud makes these initiatives 
valuable. 

 Although most offenders commit 
prescription fraud to get drugs for 
personal use (due to addiction), and 
most crime prevention efforts have 
targeted this underlying cause, this 
does not lessen the importance of 
dealing with offenders who commit 
fraud strictly for financial gain. 

In 2000, the Community Antidrug Coalitions of America 
convened 15 coalition leaders to discuss prescription 
drug abuse in their communities and identify messages, 
materials, and methods to better educate the public, 
education departments, healthcare providers, and 
community-based organizations. In 2001, NIDA partnered 
with several national organizations and distributed 
400,000 postcards in several major cities with messages 
about the dangers of prescription drugs. 

 Organizations included 
the American Pharmaceutical 
Association, Pharmaceutical 
Research and Manufacturers of 
America, American Academy of 
Family Physicians, AARP, National 
Council on Patient Information and 
Education, National Community 
Pharmacists Association, and 
National Chain Drug Store 
Association. 


Campaigns such as these let offenders know that police 
and the health field are paying attention (and that they 
risk being detected). In addition, such campaigns can help 
enlist offenders' friends and relatives to provide informal 
guardianship by better detecting suspicious activity, and 
providing help before the problem escalates. 

Purdue Pharma's 10-Point Plan to Reduce Prescription 
Drug Abuse and Diversion 

1. Educate healthcare professionals about the problem. 

2. Create tamper-resistant prescription pads. 

3. Implement programs such as Painfully Obvious, a 
prescription drug abuse awareness and education initiative 
for middle and high school students (for information, see 
www.painfullyobvious.com). 

4. Provide opioid therapy documentation kits/medical 
guidelines (information about proper prescribing of opioid 
analgesics) to healthcare professionals. 

5. Distribute educational brochures about the problem. 

6. Implement prescription monitoring programs. 

7. Establish educational programs with the law enforcement 
community. 

8. Conduct research on abuse, diversion, and addiction. 

9. Curtail cross-border smuggling. 

10. Develop abuse-resistant medicines. 


Increasing the Effort Required to Commit Prescription Fraud 

4. 
Verifying prescriptions. Pharmacists should try to 
verify every prescription. This includes making callbacks 
on all phoned-in prescriptions and checking doctors' 
names, phone numbers, and DEA numbers. They should 
also keep a file of doctors in their jurisdiction, with 
contact information and signatures. Finally, if they cannot 
immediately verify a prescription, they should dispense 
only 24 hours' worth of medication, until they can do so. 

5. 
Employing security measures. Health profession 
stakeholders can use several strategies to control 
facilitators and harden targets. 

5a. Using tamper-resistant prescription pads. Such 
pads should include some or all of the following 
features: serial numbers, prescriber information, 
watermarks, intricate lines, and/or heat-or light-
sensitive messages. Each feature increases the effort 
needed to copy or alter a prescription. Several 
states have found serialized forms to be an effective 
deterrent to prescription forgery and counterfeiting.41 

5b. Increasing the precautions the practitioner's 
receptionist and answering service take. One 
practice is to use a security code to prevent people 
from impersonating the practitioner and telling the 
receptionist or answering service to hold calls or 
retrieve messages. Another is to not give out the 
practitioner's DEA number to someone not known 
(e.g., someone claiming to be calling from an insurance 
company). 


5c. Checking photo identification. Pharmacists should 
ask for photo identification to verify that people are 
who they say they are and that names match those on 
prescriptions. Oftentimes, offenders use an alias or 
have someone claiming to be a friend or relative pick 
up prescriptions. 

A similarbut as yet 
unimplementedstrategy is to take 
a fingerprint for identification 
purposes. In Pulaski (Virginia), large-
pharmacy owners successfully fought 
a proposed requirement to do so, 
and in Arizona, proposed legislation 
to take a fingerprint for Medicaid 
purposes did not pass. 

5d. Keeping prescription pads in a secure place. Easy 
access to prescription pads is a readily controllable risk 
factor for theft. The UK Department of Health issued 
a circular that outlines measures to take to secure 
prescription forms.42 The measures include keeping 
a record of forms received, keeping the supply to a 
minimum, securely storing forms, keeping access to a 
minimum, and reporting losses immediately. 

6. Prescribing drugs electronically. The prescriber 
electronically transmits prescriptions directly to the 
pharmacist. This eliminates the problems of false phoned-
in prescriptions, forged and altered prescriptions, and 
stolen prescription pads. It also eliminates pharmacist 
errors due to illegible prescriptions. In addition, the 
process itself is more accurate, cost-effective, and time-
efficient. A project in Denmark showed savings, for the 
pharmacist and patient, in time that would otherwise be 
spent on the telephone and waiting for callbacks.43 

Electronic prescribing is at different stages of exploration 
and implementation in the United States and abroad. The 
UK National Health Service was exploring the idea in 
2000. In the States, the National Association of Chain 
Drug Stores and the National Community Pharmacists 
Association (www.ncpanet.org) agreed to collaborate on a 
system in February 2003. A few smaller jurisdictions in the 


have also created pilot projects. The DEA is considering 
moving in this direction as part of its larger e-commerce 
initiative. 

7. 
Creating or changing laws regarding prescription 
fraud. Many states have implemented or changed laws to 
more effectively deal with prescription fraud. These new 
laws increase the penalty or punishment for prescription 
fraud, and/or specifically address individual aspects of 
it. For instance, the state of Florida created 893.13(7a9) 
specifically to target doctor shopping. California's Health 
and Safety Code 11173 includes the phrase "attempt to 
obtain," which allows police to charge someone even if 
he or she does not complete the fraud. Such well-defined 
laws make it easier to prosecute and convict offenders. 

8. 
Maintaining a Prescription Monitoring Program. 
Prescription Monitoring Programs (PMPs), also called 
Multiple-Copy Prescription Programs, entail varying 
methods of tracking and monitoring certain prescription 
drugs. The general goals of the programs are to educate 
and inform prescribers, pharmacists, and the public 
regarding specific prescription drugs; use information 
for public health initiatives and for early intervention 
and prevention; and assist in investigations and 
enforcement. Underlying this is the need to protect patient 
confidentiality. 

As noted in the following table, state programs vary 
widely regarding the type of monitoring used (e.g., 
triplicate or electronic), the schedule of drugs covered, 
and the type of agency administering them. 


Table
Prescription Monitoring Programs, by State 

State/Program Enactment Year/Program Type/Schedule of Drugs Covered/
Administrative Agency 

California/1939/Triplicate/electronic/II/Justice 
 
Hawaii/1943/Duplicate/II/Public Safety  
Hawaii/1992/Electronic/II, III, IV/Public Safety 

Idaho/1967/Uncopyable paper/II, III, IV/Pharmacy Board
Idaho/1997/Electronic/II, III, IV/Pharmacy Board
Idaho/1961/Electronic/II/Human Services  

Illinois/1987/Single-copy & electronic/II, III, IV, V/Public Safety   

Indiana/1987/Single-copy & electronic/II, III, IV, V/Public Safety    
Indiana/1998/Electronic/II, III, IV, V/Public Health

Kentucky/1992/Electronic/II/Public Health  

Massachusetts/1988/Electronic/II, III, IV, V/Consumer and Industry Services 
Massachusetts/1995/Electronic/II, III, IV/Pharmacy Board 

Michigan/1988/Electronic/II, III, IV, V/Consumer and Industry Services  
Michigan/1995/Electronic/II, III, IV/Pharmacy Board 

Nevada/1994/Electronic/II/Pharmacy Board

New Mexico/1972/Single-copy,serialized,electronic/II,benzodiazepine/Public Health  

New York/1972/Single-copy,serialized,electronic/II,benzodiazepine/Public Health 
New York
 
Oklahoma/1990/Electronic/II/Narcotics and Dangerous Drugs Control  
Oklahoma/1978/Electronic/II, III/Pharmacy Board 

Rhode Island/1981/Single-copy,serialized,electronic/II/Public Safety 

Texas/1981/Single-copy,serialized,electronic/II/Public Safety

Utah/1995/Electronic/II, III, IV, V/Professional Licensure
Utah/1984/Triplicate/II, III, IV, V/Pharmacy Board
 
Washington/1995/Electronic/II/Pharmacy Board 

West Virginia/1995/Electronic/II/Pharmacy Board 

 This table was current as 
of March 2001 (National 
Association of State 
Controlled Substances 
Authorities and Alliance of 
States With Prescription 
Monitoring Programs), and 
includes only those states 
that have (or have had) some 
form of PMP. The program 
enactment year is that of the 
original program, and does 
not reflect any subsequent 
changes to it. The Michigan 
and Idaho information was 
updated from www.michigan. 
gov and www.accessidaho. 
org, respectively, on March 2, 
2003. According to a General 
Accounting Office report in 
May 2002, New Mexico ended 
its program in 2000, and West 
Virginia ended its program in 
1998, but enacted legislation to 
create a new one in 2002. 


Several studies and publications have addressed how 
PMPs affect diversion and medical practice, and most 
have reported positive results.44 PMPs are successful in 
identifying and preventing drug diversion, and have had 
minimal, or no, negative impact on medical practice. 
Individual states have also assessed their programs. 

In New York, implementing the triplicate program greatly 
lowered the number of schedule II prescription forgeries. 
After adding benzodiazepine, there was a large decrease 
in the number of prescriptions filled, an increase in its 
street price, and a significant decline in the number of 
emergency department mentions of it, compared with 
an increase in the rest of the country. In addition, no 
evidence was found that this program adversely affected 
medical practice or interfered with legitimate drug use.45 

The state of Rhode Island surveyed practitioners and 
reported positive results in terms of reducing abuse 
and forgeries, and most respondents believed there 
was no problem with legitimate patients' getting their 
prescriptions filled.46 Indiana reported a sharp increase 
in the street price of Dilaudid after implementing its 
program, and Michigan found that its electronic system 
reduced handling time and did not increase cost.47 


Addressing Prescription Fraud in San Diego 

The California Department of Justice, Bureau of Narcotics Enforcement, 
established RxNET in 2002. This multifaceted team includes state agents, 
local law enforcement investigators, military police, the DEA, and a 
representative from the state's Department of Insurance. 

The overall goal of the task force is to reduce drug diversion through 
the enforcement of drug laws and investigation of prescription fraud 
offenders. Such offenders include doctors and pharmacists who illegally 
prescribe, dispense, and/or administer drugs; people who steal prescription 
forms, forge/alter prescriptions, and/or pass fraudulent prescriptions; and 
patients who use multiple doctors to get drugs. 

Task force personnel train medical professionals to identify methods 
used to illegally obtain drugs. Through the task force, there has been 
an increased exchange of information on drug diversion cases among 
law enforcement, the Medical Board of California, the Department of 
Consumer Affairs, and the Board of Pharmacy. The task force has also 
established a relationship with the district attorney's office, which has 
created a special position to handle prescription fraud cases and is working 
with RxNET to establish a streamlined Drug Court process. 

An extensive database was created to capture, track, and analyze 
information on prescription fraud cases and offenders. The task force 
also uses the state monitoring program data internally, and they hope 
to enhance the program by disseminating appropriate information to 
the various stakeholders. Currently, a fax-alert system is used to notify 
pharmacies and doctors throughout the county about offenders and scams, 
but there are plans to create a secure, free-access Internet site for clients to 
check information online. 

 This information was obtained from the RxNET mission statement, a state grant application and 
discussions with task force members. 



Reducing Rewards to Offenders 

9. Curbing distribution. Specific efforts have been made 
to limit the dosage or distribution of a particular drug for 
a target population or region. For instance, Florida and 
four other states limit OxyContin prescriptions to 120 
pills per month per patient.48 Besides dosage, the number 
of refills could be limited. When prescribers do not 
specify a refill number, patients can illegally add one. 

Removing Excuses 

10. Facilitating compliance with the law. There are 
currently three avenues to help facilitate drug offenders' 
compliance with the law: drug treatment/rehabilitation, 
Narcotics Anonymous, and Drug Court. While all have 
been evaluated extensively, none has been evaluated 
specifically for pharmaceutical abusers/prescription fraud 
offenders. Yet anecdotal evidence reveals that Drug Court 
(in conjunction with Narcotics Anonymous, attendance 
of which is a requirement) is the most promising because 
there are ramifications if the offender does not fulfill 
the commitments. One distinct advantage of Drug Court 
(over jail) is that upon successful completion, the charges 
are expunged from the offender's record. This is especially 
important to professionals who do not want a black 
mark on their records. Because of the high number of 
prescription fraud offenders who are professionals (many 
in the healthcare field), police investigators believe this is 
potentially a very effective response. 

 You can get more information 
about Drug Court through your local 
jurisdiction or from the national 
website, at www.nadcp.org.


Responses With Limited Effectiveness 

Because most of the responses discussed here have not 
been evaluated, it is difficult to determine which ones 
have limited effectiveness. Some feel that the existing state 
monitoring systems, while effective, would be even more 
so if all states had such programs, and program databases 
were nationally linked.49 One article noted, "Despite 
triplicate prescriptions, new laws, and an increasing web of 
regulations designed to control prescription medications, 
the abuse of prescription drugs has continued."50 Another 
stated, "Increased police investigations and the threat of 
federal prison have not slowed the OxyContin pipeline to 
Kentucky."51 

11. Using crackdowns. Crackdowns usually yield 
an immediate but limited impact, and often do not 
produce long-term results. A police or medical board 
crackdown on a specific doctor or pharmacy prone to 
prescription fraud may put that doctor or pharmacy out 
of commission, but prescription drug abusers will simply 
move on to the next doctor or pharmacy that does not 
have sufficient prevention measures in place. Given the 
inadequate amount of resources devoted to crackdowns 
on prescription fraud, the practice cannot be sustained 
as a means to prevent or reduce the problem. (For a 
discussion of law enforcement efforts in particular, see 
The Benefits and Consequences of Police Crackdowns, Response 
Guide No. 1 in this series.) 



12. Creating a prescription database. Many pharmacies 
maintain a database of their customers. These "patient 
profiles" track previous prescriptions filled and provide 
information that aids in filling current ones. Although a 
pharmacist may note repeat prescriptions at his or her 
pharmacy, a customer's attempts to get prescriptions filled 
at other pharmacies go undetected. Only a limited number 
of chain pharmacies share a common database, and we are 
not aware of any database shared among all pharmacies 
in a jurisdiction. A customer's getting a high number 
of prescriptions filled at multiple pharmacies in one city 
is much more efficiently detected through a jurisdiction-
wide prescription database. The Internet would be an easy 
means to share such information. 

 In 1999, the Pharmacy Guild 
of Australia established a patient 
database that links 66 of its 5,000 
member pharmacies with each other, 
as well as with the Health Insurance 
Commission. No evaluations have 
been done on the effectiveness of 
this initiative.


Appendix 

Appendix: Summary of Responses to 
Prescription Fraud 

The table below summarizes the responses to prescription 
fraud, the mechanism by which they are intended to work, 
the conditions under which they ought to work best, and 
some factors you should consider before implementing a 
particular response. It is critical that you tailor responses 
to local circumstances, and that you can justify each 
response based on reliable analysis. In most cases, an 
effective strategy will involve implementing several 
different responses. Law enforcement responses alone are 
seldom effective in reducing or solving the problem. 

Response 
No. 
Page No. Response How It Works Works Best If Considerations 
Increasing the Risk of Detection 
1. 21 Informing 
doctors and 
pharmacists 
of fraudulent 
activity 
Sharing 
information 
on offenders 
and scams 
through bulletins 
and mass 
communication 
increases the risk 
of apprehension, 
thereby deterring 
potential 
offenders 
the 
information 
is shared 
throughout the 
jurisdiction, and 
quickly 
A means of 
networking/
communication 
that reaches the 
most people 
possible (e.g., 
faxes or the 
Internet) should 
be used 
2. 22 Improving 
pharmacists' 
screening ofprescriptions and 
patients 
Pharmacists act 
as "gatekeepers" 
by checking ID, 
verifying doctor 
information, 
and detecting 
suspicious 
behavior 
pharmacists 
are consistent 
in screening and 
report fraudulent 
activity to police 
Takes time, 
effort, and 
experience, both 
for pharmacists 
and police 


Response 
No. 
Page No. Response How It Works Works Best If Considerations 
3. 22 Educating the 
public about 
prescription 
abuse and fraud 
Increasing the 
awareness of 
prescription 
abuse and fraud 
through local 
and national 
efforts allows 
more people 
to identify 
friends and 
family members 
engaged in 
fraudulent 
activity 
informational 
campaigns are 
multidisciplinary 
and target 
specific 
populations 
Initiatives should 
provide statistics 
and other specific 
information (e.g., 
if the target 
group is youth, 
use youth-related 
data); can be 
resource-intensive 
Increasing the Effort Required to Commit Prescription Fraud 
4. 24 Verifying 
prescriptions 
Pharmacists 
do callbacks 
on phoned-in 
prescriptions and 
check doctors' 
information, 
maintain a file 
of doctors, 
and dispense 
only a limited 
dosage until 
they can verify 
prescriptions 
pharmacists 
are consistent in 
the verification 
process, refuse to 
fill unverifiable 
prescriptions, 
and report 
suspicious 
activity to police 
Takes time, effort, 
and resources 
5. 24 Employing 
security 
measures 
Strategies 
include using 
tamper-resistant 
prescription 
pads, increasing 
the precautions 
the practitioner's 
receptionist 
and answering 
service take, 
checking photo 
ID, and keeping 
prescription pads 
in a secure place, 
all increasing 
the difficulty 
for would-be 
offenders 
Direct 
all security 
measures are 
consistently 
used, and fraud 
is not being 
committed 
internally (by 
employees of the 
doctor's office) 
Tamper-resistant 
pads can be 
costly; checking 
ID can be time-
consuming; 
measures are 
ineffective against 
internal fraud 


Response 
No. 
Page No. Response How It Works Works Best If Considerations 
6. 25 Prescribing 
drugs 
electronically 
transmission of 
prescriptions 
(via computer) 
from prescribers 
to pharmacists 
eliminates the 
problems offalse phoned-in 
prescriptions, 
forged and 
altered 
prescriptions, 
and stolen 
prescription pads 
all pharmacists 
and prescribers 
in the 
jurisdiction are 
doing so 
Cost of setting 
up systems and 
maintaining 
system security; 
getting buy-in 
from doctors and 
pharmacists; once 
implemented, very 
cost-effective and 
time-efficient 
7. 26 Creating or 
changing laws 
regarding 
prescription 
fraud 
Specific, 
targeted laws 
make it easier 
to prosecute 
and convict 
offenders 
used in 
conjunction with 
other prevention 
and education 
efforts 
Can be time-and 
resource-intensive; 
does not address 
the underlying 
problem 
8. 26 Maintaining a 
Prescription 
Monitoring 
Program 
Tracking and 
monitoring 
prescription 
drugs aids in 
identifying 
patterns ofproblem 
behavior 
the program 
covers the drugs 
most often 
abused, and 
data are used 
proactively 
Patient 
confidentiality; 
limited to only 
the drugs covered 
(which varies by 
state); cost ofadministering the 
program 
Reducing Rewards to Offenders 
9. 30 Curbing 
distribution 
Limiting the 
dosage or 
distribution of 
a drug reduces 
the opportunity 
for offenders 
to easily obtain 
large quantities 
of it 
focused on 
a particular 
problem drug 
or target group/
region 
There will always 
be exceptions: 
patients who need 
higher dosages 
or more frequent 
refills 


Response 
No. 
Page No. Response How It Works Works Best If Considerations 
Removing Excuses 
10. 30 Facilitating 
compliance with 
the law 
Programs 
such as drug 
treatment/ 
rehabilitation, 
Narcotics 
Anonymous, and 
Drug Court help 
to prevent repeat 
offenses 
used in 
conjunction with 
one another, 
there are 
consequences for 
nonparticipation, 
and offenders 
want to change 
Resources are 
needed to ensure 
attendance and 
compliance with 
program rules 
Responses With Limited Effectiveness 
11. 31 Using 
crackdowns 
Police and/or 
medical boards 
target specific 
doctors or 
pharmacies to 
identify and 
curtail illegal 
activity 
the effort can 
be sustained for 
multiple people 
or pharmacies 
over an extended 
period 
Extensive 
resources are 
required (and not 
generally available); 
without prevention 
measures in place, 
illegal activity will 
resume in the long 
term 
12. 32 Creating a 
prescription 
database 
Pharmacies 
are able to 
verify patient 
information 
and monitor 
the number of 
prescriptions 
previously issued 
multipleor 
allpharmacies in 
the jurisdiction 
share the 
database 
Cost of, and 
cooperation 
required for, 
implementing 
a networked 
system; patient 
confidentiality 


AppendixEndnotes 37 
Endnotes 
1 National Drug Intelligence Center (2000). 
2 National Drug Strategy Network (1996). 
3 Zickler (2001). 
4 Mitka (2000). 
5 Mitka (2000). 
6 Payne and Dabney (1997). 
7 Substance Abuse and Mental Health Services Administration (2002b). 
8 Substance Abuse and Mental Health Services Administration (2003). 
9 Substance Abuse and Mental Health Services Administration (2003). 
10 Substance Abuse and Mental Health Services Administration (2002a). 
11 Palm Beach County Sheriff's Department (2003). 
12 National Drug Intelligence Center (2000). 
13 Substance Abuse and Mental Health Services Administration (2003). 
14 Substance Abuse and Mental Health Services Administration (2003). 
15 Ramer (2001). 
16 National Drug Intelligence Center (2001b). 
17 Kalb (2001). 
18 Schober (2001). 
19 Ramer (2001). 
20 Mitka (2000). 
21 National Institute on Drug Abuse (2002). 
22 Substance Abuse and Mental Health Services Administration (2003). 
23 Ramer (2001). 
24 National Drug Intelligence Center (2000). 
25 National Institute on Drug Abuse (2002). 
26 National Institute on Drug Abuse (2002). 
27 National Institute on Drug Abuse (2002). 
28 Mitka (2000). 
29 National Institute on Drug Abuse (2002). 
30 National Drug Intelligence Center (2000). 
31 Ramer (2001). 
32 Aiken (2001). 
33 U.S. Drug Enforcement Administration (2000b). 
34 Wilford (1990). 


35 

Fountain et al. (1997). 

36 

Fountain et al. (1997). 

37 

National Drug Intelligence Center (2001a). 

38 

U.S. Drug Enforcement Administration (2000b). 

39 

Wick (1995). 

40 

Clarke (1997). 

41 

National Association of State Controlled Substances Authorities and 
Alliance of States With Prescription Monitoring Programs (2002)
.

42 

UK Department of Health (1998). 

43 

Middleton (2000). 

44 

Joranson et al. (2002); U.S. Drug Enforcement Administration (2000a); U.S. 
General Accounting Office (1992, 2002). 

45 

Cooper et al. (1993). 

46 

Cooper et al. (1993). 

47 

Forgione, Neuenschwander, and Vermeer (2001). 

48 

Florida Department of Law Enforcement (2001). 

49 

Wesson and Smith (1990). 

50 

Wesson and Smith (1990). 

51 

Goetz (2001). 


References 

Aiken, J. (2001). "City Targets Illegal Prescription Drug 
Trade." www.cnn.com/2001/HEALTH/04/10/drug. 
diversion. 

Alliance of States With Prescription Monitoring Programs 
(1999). The Goals of Prescription Monitoring. Waltham 
(Massachusetts): Alliance of States With Prescription 
Monitoring Programs. 

Clarke, R. (ed.) (1997). Situational Crime Prevention: Successful 
Case Studies (2nd ed.). Albany (New York): Harrow and 
Heston. 

Community Antidrug Coalitions of America (2001). 
Prescription Drug Abuse Prevention  Where Do We Go 
From Here? Alexandria (Virginia): Community Antidrug 
Coalitions of America. 

Cooper, J., D. Czechowicz, S. Molinari, and R. Petersen 
(eds.) (1993). Impact of Prescription Drug Control Systems 
on Medical Practice and Patient Care, NIDA Research 
Monograph 131. Rockville (Maryland): National 
Institute on Drug Abuse. 

Florida Department of Law Enforcement, Office of 
Statewide Intelligence (2001). Overview of Prescription 
Drug Abuse and the Oxycodone Problem in Florida. 
Tallahassee (Florida): Florida Department of Law 
Enforcement. 

Forgione, D., P. Neuenschwander, and T. Vermeer (2001). 
"Diversion of Prescription Drugs to the Black Market: 
What the States Are Doing to Curb the Tide." Journal 
of Health Care Finance 27(4):6578. 


Fountain, J., P. Griffiths, M. Farrell, M. Gossop, and J. 
Strang (1997). "Diversion Tactics: How a Sample of 
Drug Misusers in Treatment Obtained Surplus Drugs 
to Sell on the Illicit Market." International Journal of 
Drug Policy 9:159167. 

Goetz, K. (2001). "The OxyContin Pipeline: Multistate 
Network Keeps Appalachia Hooked, Cincinnati Part 
of 'Near-Epidemic.'" Cincinnati Enquirer, February 25. 

Joranson, D., G. Carrow, K. Ryan, L. Schaefer, A. Gilson, 

P. Good, J. Eadie, S. Peine, and J. Dahl (2002). "Pain 
Management and Prescription Monitoring." Journal of 
Pain and Symptom Management 23(3):231238. 

Kalb, C. (2001). "Playing With Pain Killers" Newsweek, 
April 9. 

Middleton, H. (2000). "Electronically Transmitted 
Prescriptions -A Good Idea?" The Pharmaceutical 
Journal 265(7107): 172176. 

Mitka, M. (2000). "Abuse of Prescription Drugs: Is a 
Patient Ailing or Addicted?" JAMA: Journal of the 
American Medical Association 283(9):11261130. 

National Association of Chain Drug Stores (2002). 
Community Pharmacy Projections. www.nacds.org/userassets/PDF_files/ 2002_projections.pdf. 

National Association of State Controlled Substances 
Authorities and Alliance of States With Prescription 
Monitoring Programs (2002). Prescription Monitoring 
Program Model Act. www.nascsa.org/resolutions/ 
res0201.pdf. 


AppendiRefer ces 41 
National Drug Intelligence Center (2001a). National Drug 
Threat Assessment 2002. 
www.usdoj.gov/ndic/pubs07/716/716p.pdf. 
(2001b). "OxyContin Diversion and Abuse." 
Information Bulletin (January):16. www.usdoj.gov/ 
ndic/pubs/651/651p.pdf. 
(2000). National Drug Threat Assessment 2001: The 
Domestic Perspective. Johnstown (Pennsylvania): U.S. 
Department of Justice, National Drug Intelligence 
Center. Also available at 
www.usdoj.gov/ndic/pubs/647/index.htm. 
National Drug Strategy Network (1996). "Prescription 
Drug Abuse Rivals Illicit Drug Abuse, Some See 
Double Standard in Law Enforcement." New Briefs 
 Drug Use Trends. 
www.ndsn.org/oct96/prescrip.html. 
National Institute on Drug Abuse (2002). Prescription 
Drugs: Abuse and Addiction. Research Report Series. 
www.nida.nih.gov/ResearchReports/Prescription/ 
prescription6.html. 
Palm Beach County Sheriff's Department (2003). www. 
pbso.org/units/drugdiversion. 
Payne, B., and D. Dabney (1997). "Prescription Fraud: 
Characteristics, Consequences, and Influences." Journal 
of Drug Issues 27(4):807820. 
Purdue Pharma L.P. (2002). Purdue's Antidiversion Efforts: 
Purdue Pharma's 10-Point Plan to Reduce Prescription Drug 
Abuse and Diversion Without Compromising Patient Access 
to Proper Pain Control. Stamford (Connecticut): Purdue 
Pharma L.P. 


Ramer, P. (2001). Overview of Prescription Drug Abuse and the 
Oxycodone Problem in Florida. Tallahassee, Fla.: Florida 
Department of Law Enforcement, Office of Statewide 
Intelligence. 

Schober, B. (2001). "Prescription Drug Fraud Steadily 
Rising." 
www.naddi.org/news/drugfraudrising.asp. 

Substance Abuse and Mental Health Services 
Administration (2003). "Nonmedical Use of 
Prescription-Type Drugs Among Youths and Young 
Adults." The NHSDA Report. Research Triangle Park 
(North Carolina): Research Triangle Institute. 

(2002a). Emergency Department Trends From the Drug 
Abuse Warning Network, Final Estimates, 19942001. 

Rockville (Maryland): Department of Health and 

Human Services, Office of Applied Studies. 

(2002b). Results From the 2001 National Household 
Survey on Drug Abuse: Volume I. Summary of National 
Findings. Rockville (Maryland): U.S. Department 
of Health and Human Services, Office of Applied 
Studies. 

Texas Department of Public Safety (2000). Texas 
Prescription Program. Austin: Texas Department of 
Public Safety. 

UK Department of Health (1998). "Security of 
Prescription Forms." National Health Service Circular 
1998/062. 

(1997). "Alan Milburn Takes Direct Action Against 
#100M Prescription Fraud." Press release, June 19. 


AppendiRefer ces 43 
U.S. Drug Enforcement Administration, Diversion Control 
Program (2000a). A Closer Look at State Prescription 
Monitoring Programs. Washington, D.C.: U.S. Drug 
Enforcement Administration. www.deadiversion.usdoj. 
gov/pubs/rx_monitor/index.html. 
(2000b). "A Pharmacist's Guide to Prescription 
Fraud." Informational Brochures 1(1). 
(1999). "Don't Be Scammed by a Drug Abuser." 
Informational Brochures 1(1). 
(1998). Prescription Accountability Resource 
Guide. Washington D.C.: U.S. Drug Enforcement 
Administration. 
U.S. General Accounting Office (2002). Prescription Drugs: 
State Monitoring Programs Provide Useful Tool to Reduce 
Diversion. Washington, D.C.: U.S. General Accounting 
Office. 
(1992). Prescription Drug Monitoring: States Can 
Readily Identify Illegal Sales and Use of Controlled 
Substances. Washington, D.C.: U.S. General Accounting 
Office. 
Wesson, D. and D. Smith (1990). "Prescription Drug 
Abuse." Western Journal of Medicine 152(5):613616. 
Wick, J. (1995). "Outsmarting Prescription Fraud." 
Pharmacy Times 61 (April):33, 3536. 
Wilford, B. (1990). "Abuse of Prescription Drugs." 
Addiction Medicine 152 (May):609612. 


Zickler, P. (2001). "NIDA Scientific Panel Reports on 
Prescription Drug Misuse and Abuse." Research News, 
NIDA Notes 16(3) (August). 


About the Authors 

Nancy G. La Vigne 

Nancy G. La Vigne is a senior research associate at the Urban Institute 
in Washington, D.C. She directs several projects related to prisoner 
reentry, including a multi-state, longitudinal study of the reentry 
experience. Dr. La Vigne has extensive experience in criminal justice 
research, crime policy, and the legislative process and has published 
research in the areas of situational crime prevention, community 
policing, and geographic analysis of crime. She was the founding 
director of the National Institute of Justice's Crime Mapping Research 
Center; research director for the Texas Punishment Standards 
Commission; and a consultant to the Police Executive Research Forum, 
the National Council on Crime and Delinquency, and the National 
Development and Research Institute. Dr. La Vigne holds a doctorate 
from Rutgers University and a master's degree in public affairs from the 
University of Texas at Austin. 

Julie Wartell 

Julie Wartell is the crime analyst coordinator for the San Diego District 
Attorney's Office. She was previously the project director of the East 
Valley COMPASS (Community Mapping, Planning, and Analysis for 
Safety Strategies) initiative, a crime analyst for the San Diego Police 
Department, senior research and technology associate at the Institute 
for Law & Justice, a research associate at the Police Executive Research 
Forum, and a fellow at the National Institute of Justice Crime Mapping 
Research Center. Ms. Wartell has conducted a wide range of research 
on various crime problems and police issues, worked on the San Diego 
Police Department's strategic plan, coordinated the development of 
a series of crime mapping training modules, and conducted extensive 


training of police officers and crime analysts in crime analysis 
and problem-oriented policing. She has edited or authored 
numerous publications, including Crime Mapping Case Studies: 
Successes in the Field. Ms. Wartell holds a master's degree in 
public administration from San Diego State University and 
a bachelor's degree from the University of California at San 
Diego. 


Recommended Readings 

 
A Police Guide to Surveying Citizens and Their 
Environments, Bureau of Justice Assistance, 1993. This 
guide offers a practical introduction for police practitioners 
to two types of surveys that police find useful: surveying 
public opinion and surveying the physical environment. It 
provides guidance on whether and how to conduct cost-
effective surveys. 
 
Assessing Responses to Problems: An 
Introductory Guide for Police Problem-Solvers, 

by John E. Eck (U.S. Department of Justice, Office of 
Community Oriented Policing Services, 2001). This guide 
is a companion to the Problem-Oriented Guides for Police series. 
It provides basic guidance to measuring and assessing 
problem-oriented policing efforts. 

 
Conducting Community Surveys, by Deborah Weisel 
(Bureau of Justice Statistics and Office of Community 
Oriented Policing Services, 1999). This guide, along with 
accompanying computer software, provides practical, basic 
pointers for police in conducting community surveys. The 
document is also available at www.ojp.usdoj.gov/bjs. 
 
Crime Prevention Studies, edited by Ronald V. Clarke 
(Criminal Justice Press, 1993, et seq.). This is a series of 
volumes of applied and theoretical research on reducing 
opportunities for crime. Many chapters are evaluations of 
initiatives to reduce specific crime and disorder problems. 


 
Excellence in Problem-Oriented Policing:The 
1999 Herman Goldstein Award Winners. This 
document produced by the National Institute of Justice 
in collaboration with the Office of Community Oriented 
Policing Services and the Police Executive Research Forum 
provides detailed reports of the best submissions to the 
annual award program that recognizes exemplary problem-
oriented responses to various community problems. A 
similar publication is available for the award winners from 
subsequent years. The documents are also available at 
www.ojp.usdoj.gov/nij. 
 
Not Rocket Science? Problem-Solving and Crime 
Reduction, by Tim Read and Nick Tilley (Home Office 
Crime Reduction Research Series, 2000). Identifies and 
describes the factors that make problem-solving effective 
or ineffective as it is being practiced in police forces in 
England and Wales. 
 
Opportunity Makes the Thief: Practical Theory 
for Crime Prevention, by Marcus Felson and Ronald V. 
Clarke (Home Office Police Research Series, Paper No. 98, 
1998). Explains how crime theories such as routine activity 
theory, rational choice theory and crime pattern theory 
have practical implications for the police in their efforts to 
prevent crime. 
 
Problem Analysis in Policing, by Rachel Boba (Police 
Foundation, 2003). Introduces and defines problem 
analysis and provides guidance on how problem analysis 
can be integrated and institutionalized into modern 
policing practices. 


 
Problem-Oriented Policing, by Herman Goldstein 
(McGraw-Hill, 1990, and Temple University Press, 1990). 
Explains the principles and methods of problem-oriented 
policing, provides examples of it in practice, and discusses 
how a police agency can implement the concept. 
 
Problem-Oriented Policing and Crime Prevention, 
by Anthony A. Braga (Criminal Justice Press, 2003). 
Provides a thorough review of significant policing research 
about problem places, high-activity offenders, and repeat 
victims, with a focus on the applicability of those findings 
to problem-oriented policing. Explains how police 
departments can facilitate problem-oriented policing by 
improving crime analysis, measuring performance, and 
securing productive partnerships. 
 
Problem-Oriented Policing: Reflections on the 
First 20 Years, by Michael S. Scott (U.S. Department of 
Justice, Office of Community Oriented Policing Services, 
2000). Describes how the most critical elements of 
Herman Goldstein's problem-oriented policing model have 
developed in practice over its 20-year history, and proposes 
future directions for problem-oriented policing. The report 
is also available at www.cops.usdoj.gov. 
 
Problem-Solving: Problem-Oriented Policing in 
Newport News, by John E. Eck and William Spelman 
(Police Executive Research Forum, 1987). Explains the 
rationale behind problem-oriented policing and the 
problem-solving process, and provides examples of 
effective problem-solving in one agency. 


 
Problem-Solving Tips: A Guide to Reducing 
Crime and Disorder Through Problem-Solving 
Partnerships by Karin Schmerler, Matt Perkins, Scott 
Phillips, Tammy Rinehart and Meg Townsend. (U.S. 
Department of Justice, Office of Community Oriented 
Policing Services, 1998) (also available at www.cops.usdoj. 
gov). Provides a brief introduction to problem-solving, 
basic information on the SARA model and detailed 
suggestions about the problem-solving process. 
 
Situational Crime Prevention: Successful Case 
Studies, Second Edition, edited by Ronald V. Clarke 
(Harrow and Heston, 1997). Explains the principles and 
methods of situational crime prevention, and presents over 
20 case studies of effective crime prevention initiatives. 
 
Tackling Crime and Other Public-Safety 
Problems: Case Studies in Problem-Solving, by 
Rana Sampson and Michael S. Scott (U.S. Department of 
Justice, Office of Community Oriented Policing Services, 
2000) (also available at www.cops.usdoj.gov). Presents case 
studies of effective police problem-solving on 18 types of 
crime and disorder problems. 
 
Using Analysis for Problem-Solving: A Guidebook 
for Law Enforcement, by Timothy S. Bynum (U.S. 
Department of Justice, Office of Community Oriented 
Policing Services, 2001). Provides an introduction for 
police to analyzing problems within the context of 
problem-oriented policing. 
 
Using Research: A Primer for Law Enforcement 
Managers, Second Edition, by John E. Eck and Nancy G. 
LaVigne (Police Executive Research Forum, 1994). Explains 
many of the basics of research as it applies to police 
management and problem-solving. 


Other Problem-Oriented Guides for Police 

Problem-Specific Guides series: 

1. 
Assaults in and Around Bars. Michael S. Scott. 2001. 
ISBN: 1-932582-00-2 
2. 
Street Prostitution. Michael S. Scott. 2001. ISBN: 1-932582-01-0 
3. 
Speeding in Residential Areas. Michael S. Scott. 2001. 
ISBN: 1-932582-02-9 
4. 
Drug Dealing in Privately Owned Apartment Complexes. 
Rana Sampson. 2001. ISBN: 1-932582-03-7 
5. 
False Burglar Alarms. Rana Sampson. 2001. ISBN: 1-932582-04-5 
6. 
Disorderly Youth in Public Places. Michael S. Scott. 2001. 
ISBN: 1-932582-05-3 
7. 
Loud Car Stereos. Michael S. Scott. 2001. ISBN: 1-932582-06-1 
8. 
Robbery at Automated Teller Machines. Michael S. Scott. 2001. 
ISBN: 1-932582-07-X 
9. 
Graffiti. Deborah Lamm Weisel. 2002. ISBN: 1-932582-08-8 
10. 
Thefts of and From Cars in Parking Facilities. Ronald V. 
Clarke. 2002. ISBN: 1-932582-09-6 
11. 
Shoplifting. Ronald V. Clarke. 2002. ISBN: 1-932582-10-X 
12. 
Bullying in Schools. Rana Sampson. 2002. ISBN: 1-932582-11-8 
13. 
Panhandling. Michael S. Scott. 2002. ISBN: 1-932582-12-6 
14. 
Rave Parties. Michael S. Scott. 2002. ISBN: 1-932582-13-4 
15. 
Burglary of Retail Establishments. Ronald V. Clarke. 2002. 
ISBN: 1-932582-14-2 
16. 
Clandestine Drug Labs. Michael S. Scott. 2002. 
ISBN: 1-932582-15-0 
17. 
Acquaintance Rape of College Students. Rana Sampson. 2002. 
ISBN: 1-932582-16-9 
18. 
Burglary of Single-Family Houses. Deborah Lamm Weisel. 
2002. ISBN: 1-932582-17-7 
19. 
Misuse and Abuse of 911. Rana Sampson. 2002. 
ISBN: 1-932582-18-5 


20. Financial Crimes Against the Elderly. 

Kelly Dedel Johnson. 2003. ISBN: 1-932582-22-3 

21. 
Check and Card Fraud. Graeme R. Newman. 2003. 
ISBN: 1-932582-27-4 
22. 
Stalking. The National Center for Victims of Crime. 2004. 
ISBN: 1-932582-30-4 
23. 
Gun Violence Among Serious Young Offenders. Anthony A. 
Braga. 2004. ISBN: 1-932582-31-2 
24. 
Prescription Fraud. Julie Wartell and Nancy G. La Vigne. 2004. 
ISBN: 1-932582-33-9 
25. 
Identity Theft. Graeme R. Newman. 2004 ISBN: 1-932582-35-3 
26. 
Crimes Against Tourists. Ronald W. Glesnor and Kenneth J. Peak. 
2004 ISBN: 1-932582-36-3 

27. 
Underage Drinking. Kelly Dedel Johnson. 2004 ISBN: 1-932582-39-8 
28. 
Street Racing. Kenneth J. Peak and Ronald W. Glensor. 2004. 
ISBN: 1-932582-42-8 
29. 
Cruising. Kenneth J. Peak and Ronald W. Glensor. 2004. 
ISBN: 1-932582-43-6 

30. 
Disorder at Budget Motels. Karin Schmerler. 2005. 
ISBN: 1-932582-41-X 
31. 
Drug Dealing in Open-Air Markets. Alex Harocopos and Mike 
Hough. 2005. ISBN: 1-932582-45-2 
32. 
Bomb Threats in Schools. Graeme R. Newman. 2005. 
ISBN: 1-932582-46-0 
33. 
Illicit Sexual Activity in Public Places. Kelly Dedel Johnson. 2005. 
ISBN: 1-932582-47-9 
34. 
Robbery of Taxi Drivers. Martha J. Smith. 2005. 
ISBN: 1-932582-50-9 
35. 
School Vandalism and Break-Ins. Kelly Dedel Johnson. 2005. 
ISBN: 1-9325802-51-7 
36. 
Drunk Driving. Michael S. Scott, Nina J. Emerson, Louis B. 
Antonacci, and Joel B. Plant. 2005. ISBN: 1-932582-57-6 
37. 
Juvenile Runaway. Kelly Dedel. 2006 ISBN: 1932582-39-8 
38. 
The Exploitation of Trafficked Women. Graeme R. Newman. 
2006. ISBN: 1-932582-59-2 
39. 
Student Party Riots. Tamara D. Madensen and John E. Eck. 
2006. ISBN: 1-932582-60-6 


40. 
People with Mental Illness. Gary Cordner. 2006. 
ISBN: 1-932582-63-0 
41. 
Child Pornography on the Internet. Richard Wortley 
and Stephen Smallbone. 2006. ISBN: 1-932582-65-7 
42. 
Witness Intimidation. Kelly Dedel. 2006. 
ISBN: 1-932582-67-3 

Response Guides series: 

 
The Benefits and Consequences of Police 
Crackdowns. 

Michael S. Scott. 2003. ISBN: 1-932582-24-X 

 
Closing Streets and Alleys to Reduce Crime: Should 
You Go Down This Road? Ronald V. Clarke. 2004. 
ISBN: 1-932582-41-X 
 
Crime Prevention Publicity Campaign. 

Emmanuel Barthe. 2006 ISBN: 1-932582-66-5 

 
Shifting and Sharing Responsibility for Public Safety 
Problems. Michael S. Scott and Herman Goldstein. 
2005. ISBN: 1-932582-55-X 
 
Partnering with Businesses to Address Public Safety 
Problems. Sharon Chamard. 2006. ISBN: 1-932582-62-2 
 
Video Surveillance of Public Places. Jerry Ratcliffe. 
2006. ISBN: 1-932582-58-4 
Problem-Solving Tools series: 

 
Assessing Responses to Problems: An Introductory 
Guide for Police Problem-Solvers. John E. Eck. 2002. 
ISBN: 1-932582-19-3 
 
Researching a Problem. Ronald V. Clarke and Phyllis A. 
Schultz. 2005. ISBN: 1-932582-48-7 
 
Using Offender Interviews to Inform Police Problem 
Solving. Scott H. Decker. 2005. ISBN: 1932582-49-5 
 
Analyzing Repeat Victimization. Deborah Lamm 
Weisel. 2005. ISBN: 1-932582-54-1 


Upcoming Problem-Oriented Guides for Police 

Problem-Specific Guides 
Domestic Violence 
Bank Robbery 
Drive-by Shootings 
Disorder at Day Laborer Sites 
Crowd Control at Stadiums and Other Entertainment Venues 
Traffic Congestion Around Schools 

Problem-Solving Tools 
Risky Facilities 

Response Guides 
Crime Prevention Through Environmental Design 

For more information about the Problem-Oriented Guides for 
Police series and other COPS Office publications, please call 
the COPS Office Response Center at 800.421.6770 or visit 
COPS Online at www.cops.usdoj.gov. 


For More InForMatIon: 

U.S. Department of Justice 
Office of Community Oriented Policing Services 

1100 Vermont Avenue, N.W. 
Washington, DC 20530 

To obtain details on COPS programs, call the 
COPS Office Response Center at 800.421.6770 

Visit COPS Online at the address listed below. 

e07063400 Updated Date: July 06, 2006 
ISBN: 1-932582-33-9 

www.cops.usdoj.gov