Over the last few months, the Arizona Attorney General's Office has indicted seven Southern Arizona health-care workers on drug charges and is investigating more than a dozen more.
Targets still on the AG's investigative radar include a number of pain-management clinic doctors, said Assistant Attorney General Jesse Delaney, head of Tucson's Medicaid Fraud Control Unit.
Delaney said the doctors are known to prescribe pain medications to patients without examining them or doing follow-up lab work to make sure they aren't abusing the drugs and that the medications aren't having an adverse effect on their bodies.
Those under indictment or investigation run the gamut. Some doctors prescribe medications improperly for the financial rewards; others engage in prescription fraud. And some steal medications to sell or for their own use, Delaney said.
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One is David Scott San Julian, an ambulance-service paramedic.
For San Julian, the temptation just got to be too much. For three weeks, he couldn't stop himself.
Day after day, he shot up morphine, out of sight from his co-workers, bosses and customers, replacing the morphine he injected into his veins with saline.
He used Super Glue to replace the vial cap. It was the fingerprint left in the Super Glue that sealed his fate.
A co-worker caught on. San Julian was indicted on five felony counts in May.
He's scheduled to be sentenced today in Pima County Superior Court.
Although none of the pain-clinic doctors have been indicted yet, Delaney said they are a focus of his office because some who seek out such doctors are prescription-drug addicts exhibiting classic signs of drug-seeking behavior. They've sought prescriptions from multiple doctors, and yet these doctors make no attempt to see if that's the case, Delaney said.
Tom McNally, a special agent with the AG's office, is able to find such doctors and patients with help from the Arizona Board of Pharmacy's controlled-substance prescription-monitoring program, which tracks when prescriptions are written and filled, by whom, the type of prescription and where they are filled.
Drug theft
San Julian didn't stop at stealing morphine from the ambulances he was assigned to, Delaney said.
After being fired, San Julian donned his uniform, waited outside hospitals for ambulances to show up, walked in and asked for morphine for his "patient" on at least three occasions, Delaney said.
San Julian pleaded guilty to criminal impersonation. He could be placed on probation or sent to prison for up to two years. Under the terms of his plea agreement, he has to pay his employer up to $5,000 in restitution and $1,000 to the Medicaid Fraud Control Unit.
In another case, Marie Ann Nichols, a worker at a long-term acute-care hospital, is awaiting trial on charges alleging she stole three kinds of pain medication from work over an 11-month period. She's also accused of forging a prescription.
Prescription Fraud
Most of those indicted are accused of simple prescription fraud, Delaney said.
All anyone needs to forge a prescription is a doctor's name and controlled-substance tracking number from the Drug Enforcement Administration.
McNally has investigated cases in which office workers have swiped pre-signed, blank prescriptions. Some have forged doctors' names on stolen prescriptions and then answered the phone when the pharmacy called to verify the prescriptions' legitimacy. Still others have called in prescriptions and picked them up.
Dr. Mitchell Halter wrote prescriptions for his son using a nurse practitioner's name and then used the pain medications himself.
Halter pleaded guilty to solicitation to possess a narcotic drug. He could be placed on probation or receive up to 18 months in prison on Sept. 7. He also has to pay $1,500 to the Medicaid Fraud Control Unit.
The Arizona Medical Board filed an interim order in May prohibiting Halter from practicing medicine and writing prescriptions until he applies to the board and receives its permission to do so. Halter reported himself to the board.
Although statistics aren't readily available, McNally said prescription fraud is becoming more of a problem.
"Because of the accessibility of prescription medications and because of the perception they're not as dangerous as street drugs, prescription fraud is on the rise," McNally said.
Delaney said most of those currently under indictment are suspected of using fraudulent prescriptions to feed their addictions, but others were addicted and used fraudulent prescriptions to make some quick cash.
People who are addicted will go to whatever lengths necessary to get what they need, said McNally, the special agent.
"A great number of these people start out with a legitimate injury. They've injured a knee or their back. They get a prescription narcotic, and then they wind up abusing them," McNally said. "They'll start seeking them out through emergency rooms and doctors and then, if they have to, go to street sources.
"Once you're addicted, your lifestyle certainly changes, and you start doing things that would've been unconscionable to you before," McNally said.
Contact Kim Smith at kimsmith@azstarnet.com or 573-4241.
