Pharmacy Burglary, Robbery and Diversion

1. Pharmacy Burglary,
Robbery and Diversion
Presenters:
• Tara O’Connor Shelley, PhD, Associate Professor, Center for
the Study of Crime and Justice, Colorado State University
• Cheri Atwood, Director of Compliance, Mississippi Board of
Pharmacy
• John Harless, Lieutenant, Mississippi Bureau of Narcotics
Pharmacy Track
Moderator: Chad C. Corum, PharmD, Co-Owner and Pharmacist,
Corum Family Pharmacy, and Member, Operation UNITE Board of
Directors

2. Disclosures
Cheri Atwood; John Harless; Tara O’Connor
Shelley, PhD; and Chad C. Corum, PharmD, have
disclosed no relevant, real, or apparent personal
or professional financial relationships with
proprietary entities that produce healthcare
goods and services.

3. Disclosures
• All planners/managers hereby state that they or their
spouse/life partner do not have any financial
relationships or relationships to products or devices
with any commercial interest related to the content of
this activity of any amount during the past 12 months.
• The following planners/managers have the following to
disclose:
– John J. Dreyzehner, MD, MPH, FACOEM – Ownership
interest: Starfish Health (spouse)
– Robert DuPont – Employment: Bensinger, DuPont &
Associates-Prescription Drug Research Center

4. Learning Objectives
1. Explain the trends in diverting pharmaceuticals,
particularly in the form of pharmacy robbery
and burglary.
2. Identify preventative measures to enhance
security of pharmacies and the safety of their
staff and customers.
3. Outline strategies to reduce pharmacy burglaries
and robberies.
4. Provide accurate and appropriate counsel as
part of the treatment team.

5. Pharmacy Robbery & Burglary:
The Offender Perspective

6. Learning Objectives
1. Explain the trends in diverting pharmaceuticals,
particularly in the form of pharmacy robbery and
burglary.
2. Identify preventative measures to enhance security
of pharmacies and the safety of their staff and
customers.
3. Outline strategies to reduce pharmacy burglaries
and robberies.
4. Provide accurate and appropriate counsel as part of
the treatment team.

7. US Opioid Prescriptions Dispensed by US
Pharmacies (NIDA, 2014)

8. Diversion
• Definition: When legitimately manufactured
controlled substances are diverted from their lawful
purpose to an illicit purpose (DEA, 2013).
• Trend: Diversion of prescription drugs on the rise
since the 2000’s (most common type=pain relievers)
(NDIC, 2011).
• Examples: Robbery/Burglary of Pharmacies; Fraud;
Cargo Theft; Giving/Selling Drugs to Family/Friends.
• Data: “…data on pharmaceutical abuse and diversion
are not reliable, comprehensive or timely.” (US GAO,
2003)

9. Data Sources on
Pharmaceutical Diversion
• RxPatrol
– Proprietary industry data;
law enforcement
• National Incident Based
Reporting System
(NIBRS)
– Law enforcement;
publically available
• DEA Form 106 data
– Law enforcement
sensitive; DEA registrants
• National Drug
Intelligence Center
(NDIC)
– Law enforcement
survey; discontinued
• National Survey of
Drug Use and Health
(NSDUH)
• Monitoring the Future
Survey

10. Pharmacy Robberies for CPDs
2006-2014
0
100
200
300
400
500
600
700
800
900
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Rx Patrol
DEA
NIBRS

11. Pharmacy Burglaries for CPDs
2006-2014
0
200
400
600
800
1000
1200
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Rx Patrol
DEA
NIBRS

12. Research Goals
1. Understand the nature & extent of pharmaceutical
diversion that occurs as a result of robbery or
burglary of retail pharmacies.
2. Interview convicted offenders to document their
perspective about pharmacy crime.
3. Collect information to help prevent pharmacy crime
& enhance pharmacy safety.
4. Explore relevance of criminological theories.
a. Routine Activities Theory

13. Routine Activities Theory
• Cohen & Felson (1979); Felson (1994)
Suitable Target
Desirable, Accessible,
Visible, Valuable,
Vulnerable
Absence of
Capable
Guardian
People or official
social control
agents
Motivated
Offender
Those w/Criminal
Inclinations
CRIME

14. Methodology
• Semi-Structured Interviews w/48 Convicted
Offenders in Two Hot Spot Locations
– Ohio (32) & Florida (16)
• Interviews were transcribed verbatim & loaded into
NVivo for analysis of open ended responses.
• Coded for general theoretical concepts associated
w/Criminology and relied on an open coding strategy to
identify other emergent themes.

15. Pharmaceutical Use
• Of those who used pharmaceuticals, 90% were daily
users
• 78% had a prescription for drug of choice at some point
• Reasons for Initial Use

16. Doctors Seen/Doctor Shopping
• Of those w/Rx, 73% reported seeing more than 1
doctor/healthcare professional
• Reported Range of Doctors seen 1-100

17. Why They Do It: Pathways
to Robbery
Prescription(s) –
Legal & Fraudulent
Doctor Shopping &
ER Visits
Street Purchases &
Sales
Informal Networks
(family, friends,
acquaintances at
clinics to float)
Robbery

18. Crime Tactics
• 76% Wore Disguise
• 30% Jumped Counter
• 23% Passed Note
• 16% Use Distraction
Techniques
• 89% Used or Implied a
Weapon
• Of Those Using Weapon
– Gun (56%)
– Knife (19%)
– Explosive Device (6%)
• 22% Reported Physical
Injuries Occurred

19. Today’s Customer is
Tomorrow’s Offender
• 72% of offenders had been to the targeted pharmacy
before…almost all to fill prescriptions
• They carefully watch procedures; volume of
transactions; product delivery date & timeframes;
some examine cars to differentiate between staff &
customers

20. Geographic Tendencies:
Commuters or Marauders
• 66% target a pharmacy in home city
• Miles from home residence to pharmacy—0 to 120
miles.
• 49% traveled 6 or fewer miles

21. Key for Results
• Red = Discourager/Deterrent
• Green = Encourager
• Blue = Does not Matter
–WHY? Too dope sick or will work around it

22. “Suitable” Targets

23. Dimensions of Target Suitability
 Pharmacies are “suitable” targets…they have the
property that the offender desires, they are
accessible, and have a high value (e.g., relief,
financial).

24. Type of Pharmacy Targeted
42%
50%
4% 4% Local
Mom/Pop
National
Chain
Grocery
Warehouses

25. Ideal Pharmacy Location:
Stand Alone Parking Lot
9%
55%
36%
Discourage
Encourage
Does Not
Matter
“

26. Worst Pharmacy Location:
Grocery Store in Shopping Center
78%
2%
20% Discourage
Encourage
Does Not
Matter

27. Pharmacy Counter in Back
31%
36%
33%
Discourage
Encourage
Does Not
Matter

28. Time Delay Safes
76%
3%
21% Discourage
Encourage
Does Not
Matter

29. CAPABLE GUARDIANS

30. Three Staff Members in Pharmacy
67%
8%
25%
Discourage
Encourage
Does Not
Matter

31. Staffing in Pharmacy
90%
10%
Discourage
Encourage
Does Not
Matter
One Staff Member Two Staff Members
12%
50%
38%
Discourage
Encourage
Does Not
Matter

32. Possible Interference from Staff
46%
3%
51%
Discourage
Encourage
Does Not Matter

33. Possible Interference from
Customers
53%
47%
Discourage
Encourage
Does Not
Matter

34. MOTIVATED OFFENDERS

35. Developing Offender Typology
• Pure Addict (46%)
• Few crime skills, don’t want to hurt people, unstable;
don’t consider guardianship & target suitability.
• Hybrids (44%)
• Criminals who are also abusers (sometimes addicts),
sometimes dealers, willing to harm as a last resort; do
consider guardianship & target suitability.
• Entrepreneurs (10%)
• Pure business, trafficking, rare for abuse, willing to
harm; meticulously consider guardianship & target
suitability.

36. Addict
• General View
• Target Suitability
• Guardianship

37. Hybrid
• General View
• Target Suitability
• Guardianship

38. Entrepreneur
• General View
• Target Suitability
• Guardianship

39. Concluding Remarks
• Reduce Target Suitability
• Increase Guardianship
• Decrease Motivated Offenders
• Not all offenders are one in the same in how they
perceive criminal opportunities.
– Crime still occurred even when there were capable guardians
in place and/or target suitability was less than ideal.

40. Questions?
Tara O’Connor Shelley, Ph.D.
B 264 Clark
Center for the Study of Crime and Justice
Colorado State University
Fort Collins, CO USA
80523
970-491-0714
tara.shelley@colostate.edu

41. Burglary-Robbery-Diversion Prevention

42. Partners in Prevention

43. A Long Term Relationship
• MBN and MBP have worked together to
prevent diversion since the early 1980’s. This
partnership became much more active
beginning in 1999 when MBP started
registering pharmacy technicians.
• This frequent interaction created the perfect
environment to foster a partnership for
addressing pharmacy burglaries and
robberies.

44. Teamwork is the Key
• Mississippi utilizes a multi-disciplinary
approach to reducing diversion via burglary
and robbery
• Partners in this effort include pharmacy
owners and employees, regulatory agencies
and law enforcement
• These efforts are spearheaded by the Board of
Pharmacy and the Bureau of Narcotics

45. Information Sharing
• Partnering with a law enforcement agency
with a broad jurisdiction is important
• These agencies could include DEA Diversion,
the state police, a multi-jurisdictional task
force or metro departments
• Aligning regulatory agencies and law
enforcement provides a united front

46. What’s our Goal?

47. • To prevent the illicit diversion of
pharmaceuticals by creating a reduction in the
burglary and robbery of pharmacies

48. How will we Accomplish this?
• Gain an increased awareness of current trends in
pharmaceutical diversion
• Increase your awareness of how to physically
protect your pharmacy and employees
• Enable your staff to decrease the diversion of
pharmaceuticals
• Address any concerns you may have
• Improve your ability to identify persons that need
substance abuse treatment.

49. Burglary versus Robbery
• Burglary – “entry into a building illegally with
intent to commit a crime, especially theft” –
normally a property crime
• Robbery – “taking the property of another,
with the intent to permanently deprive the
person of that property, by means of force or
fear.” – always a violent crime

50. Burglary

51. Robbery

52. Organized Groups Versus Addict Burglars
• Organized groups often operate in multiple
states and commit multiple burglaries for
profit
• Addict burglaries are typically committed by
one or two people for the purpose of feeding
a narcotic addiction

53. Organized Groups
• “Trash Bag Gang,” “Bandana Group,” “Blue
Tub Group,” “Interstate Group”
• These groups often commit multiple
burglaries with commonalities ie targeting a
specific chain
• The crimes typically happen in multiple
jurisdictions
• Motive is most often financial

54. Addict Burglaries
• These are normally less sophisticated and
target pharmacies which the addict is familiar
with already
• A specific class of drug may be targeted.
• Motive is typically addiction
• Addict burglars often act in desperation and
act erratically

56. Internal Diversion or Theft
• This occurs when employees of medical
facilities or pharmacies take drugs for
distribution or personal consumption.
• Pharmacists, Techs or other employees
• Report any suspected theft to the Board
immediately
• Do not allow a problem employee to continue
their activities at another pharmacy

57. • Remember that you have a
duty to report any loss to
the Board and DEA
• Burglary, robbery or internal
loss
• Report may be completed
online

59. Board E-Mail
• LOSSES OF CONTROLLED SUBSTANCES
• Article XXV, Paragraph 1., for the Pharmacy
Practice Regulations requires that if a facility has
a loss of controlled substances by BURGLARY,
that such incident shall be reported directly to
the Board IMMEDIATELY. Investigations of these
burglaries is a priority of the Mississippi Bureau
of Narcotics. Please contact Lieutenant John
Harless with MBN IMMEDIATELY ON DISCOVERY
at 601-466-5471, day or night.

60. Board E-Mail continued
• Please contact the Board of Pharmacy as soon
as possible at 601-899-8880. This does not
preclude reporting of the burglary to your
local law enforcement agency.

61. Responsibility of Pharmacist –In-
Charge
• Each Pharmacist while on duty shall be
responsible for the security of the Pharmacy,
including provisions for effective control
against theft or diversion of Drugs and/or
Devices.
• The pharmacist-in-charge shall be responsible
for adequate security being maintained on
drugs in all areas of the permitted facility at all
Mississippi Pharmacy Practice Regulations

62. Responsibility of Pharmacist –In-
Charge continued
• times and is responsible for reporting any loss
or suspected loss of controlled substances or
legend drugs directly to the Board
immediately (this does not relieve any
pharmacist who discovers a loss from the
requirement of reporting the loss directly to
the Board).
Mississippi Pharmacy Practice Regulations

63. • It is the responsibility of the discovering
pharmacist to report losses or suspected
losses of controlled substances or
prescription drugs directly to the Board.
(601) 899-8880
Mississippi Pharmacy Practice Regulations

64. ARTICLE V
ACTION AGAINST PHARMACIST LICENSE
• Termination of employees suspected of theft
of pharmaceuticals or merchandise contacting
the Board prior to termination
• Failure to report directly to the Board, losses
or suspected losses of controlled substances
or medical devices from a permitted facility
Mississippi Pharmacy Practice Regulations

65. ARTICLE V-ACTION AGAINST PHARMACIST
LICENSE- CONTINUED
• Knowing or suspecting that a Pharmacist or
Pharmacy Intern is incapable of engaging in
the Practice of Pharmacy or that a Pharmacy
Technician is incapable of assisting in the
Practice of Pharmacy, with safety to the
public, is diverting or abusing controlled
substances or prescription drugs and failing to
report any relevant information to the Board
of Pharmacy.
Mississippi Pharmacy Practice Regulations

66. Public Education
• The Board of Pharmacy coordinates frequent
training for pharmacists, pharmacy
technicians and others with a vested interest
in reducing diversion
• This training may cover state and federal law,
regulatory changes and other subjects
applicable to diversion prevention

67. Building Solutions Together

68. Burglary Prevention
• Take preventative action:
• Cut hedges
• Insure external and security lights work
• Have the alarm system and all sensors checked –
vertical motion detectors
• Utilize a cellular telephone backup for alarm
• Insure all cameras are functioning and recording
– be wary of cameras that have been moved
• Make sure all doors are secured

69. Burglary Prevention
• Avoid leaving bottles of popular drugs sitting
out (ie 500 oxycodone on the front counter)
• Consider purchasing a gun/fire safe to store
controls in overnight
• Verify who your alarm company calls first –
preferably law enforcement
• Place height stickers or markers near doors to
aid in identifying suspects

70. Burglary Prevention
• Be aware of unusual behavior of patrons ie “casing”
the store
• Be wary of multiple “false” alarms within a few days –
checking response time and how alarm works
• Pay attention to any strange questions such as
weekend hours, opening or closing times, etc
• If outside workers are present at the pharmacy, request
of identities
• If in doubt, contact MBN or other law enforcement to
conduct a site visit and make recommendations

72. What to do if you are burglarized?
• Avoid tampering with any potential evidence –
fingerprints, DNA, video
• Contact law enforcement and the Board
• Conduct inventory and complete DEA form
106
• Be cognizant that burglars will victimize the
same store multiple times if it is an easy target

73. Why contact MBN if my local law
enforcement agency is there?
• MBN maintains information on all reported
burglaries not only in Mississippi, but in adjoining
states
• MBN analyzes information and looks for trends in
burglaries that cross jurisdictional lines
• MBN attempts to identify organized groups and
their methods
• MBN attempts to link other law enforcement
agencies with each other if there is evidence that
burglaries are connected

74. How to react to a robbery?
• Stay calm and remember that the safety of
you, your employees and patrons is the
priority
• Provide the perpetrator what he/she wants
within reason
• If another employee reacts poorly because of
fear, insure the bad guy that you will handle
their demands

75. • Rather than being a hero, focus on being the
best witness possible
• Observe and remember physical
characteristics such as height, weight, race,
gender, hair color, age, voice, mannerisms, etc
• Observe clothing, weapons, what they place
the drugs into, anything that they touch
• Observe any vehicles that are used

76. • Avoid allowing anyone to leave with the
suspect if at all possible
• Once the suspect(s) leave, secure the doors
and contact law enforcement immediately
• Do not disturb any potential physical evidence
• Be willing to provide or undergo any
appropriate follow up counseling

77. • In cases of addict robbery, do not treat a
suspect in a less serious manner because you
may be familiar with them from previous
contact
• Addicts commit robberies in desperate times
and are capable of unexpected actions

78. • After you have reported the burglary or
robbery to local law enforcement, contact
MBN Lieutenant John Harless at 601-466-
5471.
• Be prepared to provide law enforcement with
a copy of any security footage.

79. The Reality of Diversion
• The pharmacist is the “gate keeper” in the
fight against diversion and prescription drug
misuse.
• As medical professionals, you have a
responsibility to do everything possible to
insure that controlled substances are
dispensed in the proper manner.

80. • An inter-disciplinary approach to the
prevention of diversion by burglary and
robbery can prove to be quite effective
• Law enforcement, regulatory agencies and
pharmacy employees must improve
communication and interaction to foster these
relationships
• Do not be afraid to reach out to other vested
partners with questions and ideas

82. Pharmacy Burglary,
Robbery and Diversion
Presenters:
• Tara O’Connor Shelley, PhD, Associate Professor, Center for
the Study of Crime and Justice, Colorado State University
• Cheri Atwood, Director of Compliance, Mississippi Board of
Pharmacy
• John Harless, Lieutenant, Mississippi Bureau of Narcotics
Pharmacy Track
Moderator: Chad C. Corum, PharmD, Co-Owner and Pharmacist,
Corum Family Pharmacy, and Member, Operation UNITE Board of
Directors