U.S. Department of Justice

Office of Community Oriented Policing Services

www.cops.usdoj.gov

Prescription Fraud

by Julie Wartell

Nancy G. La Vigne

Problem-Oriented Guides for Police 

Problem-Specific Guides Series

No. 24
www.PopCenter.org

Got a Problem? We’ve got answers!

Log onto the Center for Problem-Oriented Policing website

at www.popcenter.org for a wealth of information to help

you deal more effectively with crime and disorder in your

community, including:

• Web-enhanced versions of all currently available Guides

• Interactive training exercises

• On-line access to research and police practices

Designed for police and those who work with them to

address community problems, www.popcenter.org is a great

resource in problem-oriented policing.

Supported by the Office of Community Oriented Policing

Services, U.S. Department of Justice.

Center for Problem-Oriented Policing
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

Problem-Oriented Guides for Police 

Problem-Specific Guides Series

Guide No. 24

About the Problem-Specific Guides Series i

About the Problem-Specific Guides Series

The Problem-Specific Guides summarize knowledge about

how police can reduce the harm caused by specific crime

and disorder problems. They are guides to prevention and

to improving the overall response to incidents, not to

investigating offenses or handling specific incidents. The

guides are written for police–of whatever rank or

assignment–who must address the specific problem the

guides cover. The guides will be most useful to officers

who

• Understand basic problem-oriented policing

principles and methods. The guides are not primers in

problem-oriented policing. They deal only briefly with

the initial decision to focus on a particular problem,

methods to analyze the problem, and means to assess

the results of a problem-oriented policing project. They

are designed to help police decide how best to analyze

and address a problem they have already identified. (An

assessment guide has been produced as a companion to

this series and the COPS Office has also published an

introductory guide to problem analysis. For those who

want to learn more about the principles and methods of

problem-oriented policing, the assessment and analysis

guides, along with other recommended readings, are

listed at the back of this guide.)

• Can look at a problem in depth. Depending on the

complexity of the problem, you should be prepared to

spend perhaps weeks, or even months, analyzing and

responding to it. Carefully studying a problem before

responding helps you design the right strategy, one that

is most likely to work in your community. You should

not blindly adopt the responses others have used; you

must decide whether they are appropriate to your local

situation. What is true in one place may not be true
ii Prescription Fraud

elsewhere; what works in one place may not work

everywhere.

• Are willing to consider new ways of doing police

business. The guides describe responses that other

police departments have used or that researchers have

tested. While not all of these responses will be

appropriate to your particular problem, they should help

give a broader view of the kinds of things you could do.

You may think you cannot implement some of these

responses in your jurisdiction, but perhaps you can. In

many places, when police have discovered a more

effective response, they have succeeded in having laws

and policies changed, improving the response to the

problem.

• Understand the value and the limits of research

knowledge. For some types of problems, a lot of useful

research is available to the police; for other problems, little

is available. Accordingly, some guides in this series

summarize existing research whereas other guides illustrate

the need for more research on that particular problem.

Regardless, research has not provided definitive answers to

all the questions you might have about the problem. The

research may help get you started in designing your own

responses, but it cannot tell you exactly what to do. This

will depend greatly on the particular nature of your local

problem. In the interest of keeping the guides readable, not

every piece of relevant research has been cited, nor has

every point been attributed to its sources. To have done so

would have overwhelmed and distracted the reader. The

references listed at the end of each guide are those drawn

on most heavily; they are not a complete bibliography of

research on the subject. 
About the Problem-Specific Guides Series iii

• Are willing to work with other community agencies

to find effective solutions to the problem. The police

alone cannot implement many of the responses

discussed in the guides. They must frequently implement

them in partnership with other responsible private and

public entities. An effective problem-solver must know

how to forge genuine partnerships with others and be

prepared to invest considerable effort in making these

partnerships work. 

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.

The COPS Office and the authors encourage you to

provide feedback on this guide and to report on your own

agency's 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.
iv Prescription Fraud

For more information about problem-oriented policing,

visit the Center for Problem-Oriented Policing online at

www.popcenter.org or via the COPS website at

www.cops.usdoj.gov. 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 training exercise, and

• online access to important police research and practices.
Acknowledgments v

Acknowledgments

The Problem-Oriented Guides for Police are very much a

collaborative effort. 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 principal project team developing the guide series

comprised Herman Goldstein, professor emeritus,

University of Wisconsin Law School; Ronald V. Clarke,

professor of criminal justice, Rutgers University; John E.

Eck, associate professor of criminal justice, University of

Cincinnati; Michael S. Scott, assistant clinical professor,

University of Wisconsin Law School; Rana Sampson,

police consultant, San Diego; and Deborah Lamm Weisel,

director of police research, North Carolina State

University.

Karin Schmerler, Rita Varano and Nancy Leach oversaw

the project for the COPS Office. Suzanne Fregly edited

the guides. Research for the guides was conducted at the

Criminal Justice Library at Rutgers University under the

direction of Phyllis Schultze. 

The project team also wishes to acknowledge the members

of the San Diego, National City and Savannah police

departments who provided feedback on the guides' format

and style in the early stages of the project, as well as the

line police officers, police executives and researchers who

peer reviewed each 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: Summary of Responses to Prescription Fraud . . . . . . . . . . . . . . . . . . . . . 33

Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Contents vii
viii Prescription Fraud

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Recommended Readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Other Problem-Oriented Guides for Police . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
The Problem of Prescription Fraud 1

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.

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

†

"Backdoor pharmacies" are

businesses not licensed/authorized

to distribute pharmaceutical drugs.
2 Prescription Fraud

prescription drugs each year roughly equals the number

who abuse cocaine–about 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 And

the Cincinnati Police Department's Pharmaceutical

Diversion Squad reported that, in nine years, over 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

offenses–as 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). 
The Problem of Prescription Fraud 3

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.
4 Prescription Fraud

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.7In 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
The Problem of Prescription Fraud 5

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
6 Prescription Fraud

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

The Problem of Prescription Fraud 7
8 Prescription Fraud

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
The Problem of Prescription Fraud 9

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

Prescription altered to change the number of refills from one to four
10 Prescription Fraud

Prescription altered to change the quantity from 12 to 120

Prescription altered to add a drug (Alprazolam)
The Problem of Prescription Fraud 11

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 13

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)?
14 Prescription Fraud

• 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?
Understanding Your Local Problem 15

• 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
16 Prescription Fraud

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; and

• 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

fraud–as measured by crimes reported to the police–

increases.
Responses to the Problem of Prescription Fraud 17

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. 
18 Prescription Fraud

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. †

• 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.

†

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).
Responses to the Problem of Prescription Fraud 19

• Pharmacists. In an information brochure for

pharmacists, the DEA (2000b) recommends using

common sense, sound professional practice, and proper

dispensing procedures and controls (see sidebar).

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

it–call 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).
20 Prescription Fraud

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.† 

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.††

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.

† 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.

†† Neither the 1991 evaluation nor

the 2001 funding was directly related

to the responses discussed in this

guide. 
Responses to the Problem of Prescription Fraud 21

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, N.M., 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, Kan., use a PharmAlert

hotline for notification, while Abington, Pa., 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.
22 Prescription Fraud

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 website, 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.

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. 

† 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. 

†† 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.
Responses to the Problem of Prescription Fraud 23

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,TM 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
24 Prescription Fraud

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 lightsensitive 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).
Responses to the Problem of Prescription Fraud 25

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.

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 phonedin 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 timeefficient. 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

† A similar–but as yet

unimplemented–strategy is to take a

fingerprint for identification

purposes. In Pulaski, Va., largepharmacy owners successfully

fought a proposed requirement to

do so, and in Arizona, proposed

legislation to take a fingerprint for

Medicaid purposes did not pass.
26 Prescription Fraud

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.
Responses to the Problem of Prescription Fraud 27

State

California

Hawaii

Idaho

Illinois

Indiana

Kentucky

Massachusetts

Michigan

Nevada

New Mexico

New York

Oklahoma

Rhode Island

Texas

Utah

Washington

West Virginia

Program

Enactment

Year

1939

1943

1992

1967

1997

1961

1987

1998

1992

1988

1995

1994

1972

1990

1978

1981

1995

1984

1995

Program Type

Triplicate/electronic

Duplicate

Electronic

Uncopyable paper

Electronic

Electronic

Singlecopy/electronic

Electronic

Electronic

Electronic

Electronic

Electronic

Single-copy,

serialized/electronic

Electronic

Electronic

Single-copy,

serialized/electronic

Electronic

Triplicate

Electronic

Schedule of

Drugs Covered

II

II

II, III, IV

II, III, IV

II, III, IV

II

II, III, IV, V

II, III, IV, V

II

II, III, IV, V

II, III, IV

II

II,

benzodiazepine

II

II, III

II

II, III, IV, V

II, III, IV, V

II

Administrative

Agency

Justice 

Public Safety

Pharmacy Board

Human Services

Public Safety

Public Health

Public Health

Consumer and

Industry

Services

Pharmacy Board

Pharmacy Board

Public Health

Narcotics and

Dangerous

Drugs Control

Pharmacy Board

Public Safety

Professional

Licensure

Pharmacy Board

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.

Prescription Monitoring Programs, by State†
28 Prescription Fraud

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
Responses to the Problem of Prescription Fraud 29

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.
30 Prescription Fraud

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 to the Problem of Prescription Fraud 31

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.)
32 Prescription Fraud

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 33

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.

1.

2.

21

22

Informing

doctors and

pharmacists of

fraudulent

activity

Improving

pharmacists'

screening of

prescriptions and

patients

Sharing

information on

offenders and

scams through

bulletins and

mass

communication

increases the risk

of apprehension,

thereby deterring

potential

offenders

Pharmacists act

as "gatekeepers"

by checking ID,

verifying doctor

information, and

detecting

suspicious

behavior

...the

information is

shared

throughout the

jurisdiction, and

quickly

...pharmacists are

consistent in

screening and

report fraudulent

activity to police

A means of

networking/com

munication that

reaches the most

people possible

(e.g., faxes or the

Internet) should

be used

Takes time,

effort, and

experience, both

for pharmacists

and police

Response

No.

Page No. Response How It Works Works Best If... Considerations

Increasing the Risk of Detection
34 Prescription Fraud

3.

4.

5.

22

24

24

Educating the

public about

prescription

abuse and fraud

Verifying

prescriptions

Employing

security

measures

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

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

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

...informational

campaigns are

multidisciplinary

and target

specific

populations

...pharmacists

are consistent in

the verification

process, refuse

to fill

unverifiable

prescriptions,

and report

suspicious

activity to police

...all security

measures are

consistently

used, and fraud

is not being

committed

internally (by

employees of the

doctor's office)

Initiatives should

provide statistics

and other specific

information (e.g.,

if the target group

is youth, use

youth-related

data); can be

resource-intensive

Takes time, effort,

and resources

Tamper-resistant

pads can be costly;

checking ID can

be timeconsuming;

measures are

ineffective against

internal fraud

Response

No.

Page No. Response How It Works Works Best If... Considerations

Increasing the Effort Required to Commit Prescription Fraud
Appendix 35

6.

7.

8.

9.

25

26

26

30

Prescribing

drugs

electronically 

Creating or

changing laws

regarding

prescription

fraud

Maintaining a

Prescription

Monitoring

Program

Curbing

distribution

Direct

transmission of

prescriptions (via

computer) from

prescribers to

pharmacists

eliminates the

problems of

false phoned-in

prescriptions,

forged and

altered

prescriptions,

and stolen

prescription pads

Specific, targeted

laws make it

easier to

prosecute and

convict

offenders

Tracking and

monitoring

prescription

drugs aids in

identifying

patterns of

problem

behavior 

Limiting the

dosage or

distribution of a

drug reduces the

opportunity for

offenders to

easily obtain

large quantities

of it

...all pharmacists

and prescribers

in the

jurisdiction are

doing so

...used in

conjunction with

other prevention

and education

efforts

...the program

covers the drugs

most often

abused, and data

are used

proactively

...focused on a

particular

problem drug or

target

group/region

Cost of setting up

systems and

maintaining system

security; getting

buy-in from

doctors and

pharmacists; once

implemented, very

cost-effective and

time-efficient

Can be time-and

resource-intensive;

does not address

the underlying

problem

Patient

confidentiality;

limited to only the

drugs covered

(which varies by

state); cost of

administering the

program

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

Reducing Rewards to Offenders
36 Prescription Fraud

10.

11.

12.

Facilitating

compliance with

the law

Using

crackdowns

Creating a

prescription

database

Programs such

as drug

treatment/

rehabilitation,

Narcotics

Anonymous, and

Drug Court help

to prevent repeat

offenses 

Police and/or

medical boards

target specific

doctors or

pharmacies to

identify and

curtail illegal

activity

Pharmacies are

able to verify

patient

information and

monitor the

number of

prescriptions

previously issued

...used in

conjunction with

one another,

there are

consequences for

nonparticipation,

and offenders

want to change

...the effort can

be sustained for

multiple people

or pharmacies

over an extended

period

...multiple–or

all–pharmacies in

the jurisdiction

share the

database

Resources are

needed to ensure

attendance and

compliance with

program rules

Extensive

resources are

required (and not

generally available);

without prevention

measures in place,

illegal activity will

resume in the long

term

Cost of, and

cooperation

required for,

implementing a

networked system;

patient

confidentiality

Response

No.

Page No. Response How It Works Works Best If... Considerations

30

31

32

Removing Excuses

Responses With Limited Effectiveness
Endnotes 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).
38 Prescription Fraud

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 39

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,

Mass.: Alliance of States With Prescription Monitoring

Programs.

Clarke, R. (ed.) (1997). Situational Crime Prevention: Successful

Case Studies (2nd ed.). Albany, N.Y.: Harrow and

Heston. 

Community Antidrug Coalitions of America (2001).

Prescription Drug Abuse Prevention – Where Do We Go

From Here? Alexandria, Va.: 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, Md.: 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, Fla.: 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):65–78.
40 Prescription Fraud

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 9:159–167.

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):231–238.

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

April 9.

Middleton, H. (2000). "Electronically Transmitted

Prescriptions - A Good Idea?" The Pharmaceutical

Journal 265(7107): 172–176.

Mitka, M. (2000). "Abuse of Prescription Drugs: Is a

Patient Ailing or Addicted?" JAMA: Journal of the

American Medical Association 283(9):1126–1130.

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
References 41

National Drug Intelligence Center (2001a). National Drug

Threat Assessment 2002.

http://www.usdoj.gov/ndic/pubs07/716/716p.pdf.

(2001b). "OxyContin Diversion and Abuse."

Information Bulletin (January):1–6.

http://www.usdoj.gov/ndic/pubs/651/651p.pdf

(2000). National Drug Threat Assessment 2001: The

Domestic Perspective. Johnstown, Pa.: U.S. Department of

Justice, National Drug Intelligence Center. Also

available at

http://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.

http://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/pres

cription6.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):807–820.

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, Conn.: Purdue Pharma

L.P.
42 Prescription Fraud

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."

http://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,

N.C.: Research Triangle Institute.

(2002a). Emergency Department Trends From the Drug

Abuse Warning Network, Final Estimates, 1994–2001.

Rockville, Md.: 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, Md.: U.S. Department of Health

and Human Services, Office of Applied Studies.

Texas Department of Public Safety (2000). Texas

Prescription Program. Austin, Texas: 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.
References 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.

http://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):613–616.

Wick, J. (1995). "Outsmarting Prescription Fraud."

Pharmacy Times 61 (April):33, 35–36.

Wilford, B. (1990). "Abuse of Prescription Drugs."

Addiction Medicine 152 (May):609–612.
44 Prescription Fraud

Zickler, P. (2001). "NIDA Scientific Panel Reports on

Prescription Drug Misuse and Abuse." Research News,

NIDA Notes 16(3) (August).
About the Authors 45

About the Authors

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 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 47

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 costeffective 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.
48 Prescription Fraud

• 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 problemoriented 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.
Recommended Readings 49

• 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 through 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.
50 Prescription Fraud

• 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 51

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
52 Prescription Fraud

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, Nancy G. La Vigne. 2004.

ISBN: 1-932582-33-9

Response Guides series:

• The Benefits and Consequences of Police Crackdowns. 

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

Problem-Solving Tools series: 

• Assessing Responses to Problems: An Introductory Guide for

Police Problem-Solvers. John E. Eck. 2002. ISBN:1-932582-19-3

Upcoming Problem-Oriented Guides for Police (2004)

Problem-Specific Guides

Crimes Against Tourists

Disorder at Budget Motels

Domestic Violence

Mentally Ill Persons

Robbery of Taxi Drivers

Student Party Disturbances on College Campuses

Response Guides

Closing Streets and Alleys to Reduce Crime

Problem-Solving Tools

Repeat Victimization

Using Offender Interviews to Inform Police Problem-Solving
Other Problem-Oriented Guides for Police 53

Future Guide Topics (2004)

Identity Theft 

School Break-Ins

Street Racing

Bomb Threats in Schools

Underage Drinking

Open-Air Drug Markets

Controlling Sexual Activity in Public Places

Drunk Driving

Cruising

Bank Robbery

Other Related COPS Office Publications

• Using Analysis for Problem-Solving: A Guidebook

for Law Enforcement. Timothy S. Bynum. 

• Problem-Oriented Policing: Reflections on the First

20 Years. Michael S. Scott. 2001.

• Tackling Crime and Other Public-Safety Problems:

Case Studies in Problem-Solving. Rana Sampson and

Michael S. Scott. 2000.

• Community Policing, Community Justice, and

Restorative Justice: Exploring the Links for the

Delivery of a Balanced Approach to Public Safety.

Caroline G. Nicholl. 1999.

• Toolbox for Implementing Restorative Justice and

Advancing Community Policing. Caroline G. Nicholl.

2000.

• Problem-Solving Tips: A Guide to Reducing

Crime and Disorder Through Problem-Solving

Partnerships. Karin Schmerler, Matt Perkins, Scott

Phillips, Tammy Rinehart and Meg Townsend. 1998.
54 Prescription Fraud

• Bringing Victims into Community Policing. The

National Center for Victims of Crime and the Police

Foundation. 2002.

• Call Management and Community Policing. Tom

McEwen, Deborah Spence, Russell Wolff, Julie Wartell

and Barbara Webster. 2003.

• Crime Analysis in America. Timothy C. O’Shea and

Keith Nicholls. 2003.

• Problem Analysis in Policing. Rachel Boba. 2003.

• Reducing Theft at Construction Sites: Lessons

From a Problem-Oriented Project. Ronald V. Clarke

and Herman Goldstein. 2003.

• The COPS Collaboration Toolkit: How to Build,

Fix, and Sustain Productive Partnerships. Gwen O.

Briscoe, Anna T. Laszlo and Tammy A. Rinehart.

2001. 

• The Law Enforcement Tech Guide: How to plan,

purchase and manage technology (successfully!).

Kelly J. Harris and William H. Romesburg. 2002.

• Theft From Cars in Center City Parking 

Facilities - A Case Study. Ronald V. Clarke and

Herman Goldstein. 2003.

For more information about the Problem-Oriented Guides for

Police series and other COPS Office publications, please call

the Department of Justice 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, D.C. 20530

To obtain details on COPS programs, call the

U.S. Department of Justice Response Center at 800.421.6770

Visit COPS Online at the address listed below.

e04042311 Updated Date: May 26, 2004

ISBN: 1-932582-33-9

www.cops.usdoj.gov