Two Unique Approaches Dr. Gary Mar7n Homicide Detec7ve, Palm Beach County (FL) Sheriﬀ’s Department Jason Parman Assistant U.S. AJorney, London, KY April 2 – 4, 2013 Omni Orlando Resort at ChampionsGate
Lesson Objec7ve 1. Outline inves7ga7ve priori7es in building an overdose death prosecu7on. 2. State the beneﬁt of building strategic coopera7on between federal and state law enforcement agencies. 3. Demonstrate how law enforcement can work together with community preven7on programs in inves7ga7ons.
Overdose Suppression Project: A Comprehensive Response
• Law Enforcement • Public Awareness • Quan6ta6ve Research
• Reviewing each overdose death inves7ga7on. • Applying all relevant statutes to the circumstances. • Forwarding all narco7cs intelligence. • 19.3 % of the case reviews generated narco7cs intelligence.
• Overdose and poisoning should be ruled out in all cases of non-‐violent deaths.
• Scene Inves7ga7on • Physical Examina7on of the Decedent • Autopsy Results • Toxicology Findings
If a person dies of an apparent drug overdose: (1) A law enforcement agency shall prepare a report iden7fying each prescribed controlled substance listed in Schedule II, Schedule III, or Schedule IV of s. 893.03 which is found on or near the deceased or among the deceaseds possessions. The report must iden7fy the person who prescribed the controlled substance, if known or ascertainable. Thereaeer, the law enforcement agency shall submit a copy of the report to the medical examiner. (2) A medical examiner who is preparing a report pursuant to s. 406.11 shall include in the report informa7on iden7fying each prescribed controlled substance listed in Schedule II, Schedule III, or Schedule IV of s. 893.03 that was found in, on, or near the deceased or among the deceaseds possessions.
• All prescrip6on drug containers (including empty containers) should be photographed, seized, and then individually described on a property receipt. • All unﬁlled prescrip6on authoriza6ons “scripts” should be photographed, seized, and individually described on a property receipt. • All illegal drug containers (plas6c baggies, ﬁlm vials, e.t.c.) should be handled in such a way that poten6al trace evidence could be extracted. • Within reason, samples of drinking ﬂuids discovered within the immediate area of the suspected overdose death should be collected.
Evaluate physical evidence of prescrip7on drug abuse and diversion by the decedent: • Appointment cards • Address/phone books • Cell phones/caller id • Personal computers • Calendars • Prescrip7on vials • Unﬁlled scripts • Pharmacy receipts • Drug warning documents
• Forging coopera6ve rela6onships with families who have lost loved ones to drug overdose death. • Providing overdose risk awareness programs to students and parents. • Designing a mul6media public service campaign focusing on the risks associated with prescrip6on drug misuse and abuse. • Seeking legisla6ve ac6on to discourage doctor shopping and prescrip6on drug diversion.
Ineﬀec7ve Remedies • Do NOT put them in an ice cold bath. • Do NOT inject them with salt water or milk. • Do NOT give them s7mulants (like cocaine, methamphetamine, or Adderall). • Do NOT give them food or water or induce vomi7ng (they could choke) • Do NOT leave them alone. • If you must leave, call 911 ﬁrst and leave them in the recovery posi7on.
• A Drug Overdose Interven7on Strategy. • Oﬀers-‐limited immunity from criminal prosecu7on for person(s) who, in good faith, seek medical aJen7on during a drug-‐related medical crisis. • Intent-‐reduce the number of drug overdose deaths by removing the fear of arrest as a barrier to seeking emergency medical assistance.
911 Good Samaritan 893.21 Drug-‐related overdoses; medical assistance; immunity from prosecu6on. • (1) A person ac7ng in good faith who seeks medical assistance for an individual experiencing a drug-‐related overdose may not be charged, prosecuted, or penalized pursuant to this chapter for possession of a controlled substance if the evidence for possession of a controlled substance was obtained as a result of the person’s seeking medical assistance. • (2) A person who experiences a drug-‐related overdose and is in need of medical assistance may not be charged, prosecuted, or penalized pursuant to this chapter for possession of a controlled substance if the evidence for possession of a controlled substance was obtained as a result of the overdose and the need for medical assistance. • (3) Protec7on in this sec7on from prosecu7on for possession oﬀenses under this chapter may not be grounds for suppression of evidence in other criminal prosecu7ons. • This act shall take eﬀect October 1, 2012.
• Collec7ng extensive demographic and circumstan7al data from each overdose death inves7ga7on. • Designing a prac7cal overdose death database. • Exposing overdose correla7ons and trends.
Case Examina6ons • 353 overdose death cases • Palm Beach County, Florida • Selected by chronological occurrence • Data derived from: Police and paramedic reports Autopsy and toxicology ﬁndings Family and friend interviews Medical records
• White • Male • Approximately 40 years old • High School Diploma or GED • Employed
• History of substance abuse • History of drug related arrests • History of substance abuse treatment • History of mental health treatment • History of non fatal drug overdose • Under physician’s care at 7me of death
• Died at home • Discovered by family member • Last act is sleeping • Found unconscious • Others present at death scene • Other recognized distress • Died from accidental mul7ple drug toxicity • Most likely combina7ons are alprazolam, oxycodone, cocaine, and methadone.
Detec7ve Gary Mar7n Violent Crimes Division – Homicide Unit Palm Beach County Sheriﬀ’s Oﬃce West Palm Beach, Fl 33406 561-‐688-‐4058 email@example.com Or Gary Mar7n, Ed.D. Associate Dean For Student Life Lynn University Boca Raton, Fl 33431 561-‐237-‐7157 firstname.lastname@example.org
Two Unique Approaches April 2 – 4, 2013 Omni Orlando Resort at ChampionsGate
Learning Objec6ves • 1. Outline inves7ga7ve priori7es in building an overdose death prosecu7on. • 2. State the beneﬁt of building strategic coopera7on between federal and state law enforcement agencies. • 3. Demonstrate how law enforcement can work together with community preven7on programs in inves7ga7ons.
Controlled Substances Act covers overdose deaths 21 USC 841(A)(1): 1. Knowing distribu7on of controlled substance 2. Death results from use of controlled substance 21 USC 846: 1. Two or more people must conspire to distribute a controlled substance 2. Death results from use of controlled substance
Inves7ga7ve Priori7es What caused the death? Who did it?• Medical examiner’s report essen7al – • Witnesses who observed drug work to develop rela7onships with distribu7on to the deceased? coroners • For prescrip7on overdoses, tracking the • Toxicology report helpful, but not disposi7ve paper trail is useful • Do NOT have to prove intent to kill, • Standard drug inves7ga7ons is recklessness, foreseeability, or other important parallel mental state rela7ve to the death • The element that must be proven is “Did death result from the use of the controlled substance?” • Distributed drug does not have to be exclusive or primary cause of death, only had to have played a part.
“Tradi7onal” TARGETS Sponsors, Brokers, Direct Distributors • Developing sources of informa7on / cooperators key • Establish rela7onships between targets rela7ve to date of distribu7on • Was target in the chain of distribu7on that led to the death • Tracking the line from the end user to the drug source reveals poten7al targets (All in the chain are poten7al defendants as long as distribu7on to end user was reasonably foreseeable)
POTENTIAL TARGETS Doctors / Pharmacists • Need to show target prescribed / ﬁlled medica7on without legi7mate medical purpose outside the usual course of professional treatment • PaJern of pa7ents help to establish unlawful distribu7on • Cash only clientele • Superﬁcial examina7ons • Expert review of records • Cooperators beneﬁcial • Conspiratorial rela7onship between providers (warning pa7ents where to or not to ﬁll scripts)
“Death Resul7ng” Penal7es Statutory Penal6es Sentencing Guidelines 21 USC 841(b)(1)(A)-‐(C) U.S.S.G. § 2D1.1 • Mandatory Minimum 20 years • Deaths from Schedule I or II with prior with Life max convic7on for traﬃcking with similar drug is 43 (360 – life) • Applies to all Schedule I and II • No prior convic7on is 38 (235-‐293) Controlled Substances (oxycodone, methadone, etc.) • Deaths from Schedule III and IV (ie: hydrocodone, alprazolam) start at 30 (97-‐121) with prior convic7on and 26 (63-‐78) without convic7on • All ranges assume no criminal history • Ex: Criminal History I with a 38 (235-‐293) is (360 to life) with a Criminal History VI
United States v. McIntosh DEA inves6ga6on with State partnerships Result ? • What made it work? • McIntosh sentenced to 327 • First responders treated call as a months for distribu7on resul7ng crime scene vs. an accident in death (guideline range of • Autopsy that established oxycodone 292-‐327) Lowest criminal history as a contribu7ng factor in the death category • DEA later implicated McIntosh in a Who collaborated? large oxycodone conspiracy through • Kentucky State Police cooperator statements and local law • Local Law Enforcement enforcement’s street level buys • Crucial leads in the inves7ga7ve • County Coroner report from 10 months prior • State Medical Examiner • Knew the Who, What, When and • DEA Where and it was documented
Beneﬁts to “death resul7ng” prosecu7ons “Tradi6onal” Drug Dealers “Professional” Drug Dealers • Dealing is ul7mately a decision • Doctors, Pharmacists, etc. • “The nega7ve has to outweigh the • Enormous proﬁt margins for pain clinic posi7ve” owners, doctors, pharmacists • Reality is Rx diversion is a proﬁtable • $100,000 cash in one day, for example revenue plan for many • Violate your duty, responsible for the • These prosecu7ons send a simple, consequence powerful message • Given the harm produced from prescrip7on diversion, must target • Distribute prescrip7on drugs, you will those with “keys to the castle” be held responsible for the • Treats the source = to a drug dealer consequence
Ques7ons/Comments Jason D. Parman United States AJorneys Oﬃce Eastern District of Kentucky 606-‐864-‐5523 Ext. 117 Jason.Parman@usdoj.gov