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Despite probe, prescription drug abuse worsening, authorities say

By Jerry Markon
Washington Post Staff Writer
Sunday, March 14, 2010; A01

Donna M. George was a grandmother living in a gated community in Fredericksburg when she sold prescription drugs out of her kitchen -- while babysitting for her three grandchildren.

Witnesses at George's trial said she repeatedly sold them Percocet, methadone and oxycodone. Her grandchildren, 3, 5 and an infant, were watching television less than 20 feet away. "I have kids of my own, so it kind of made me real nervous," testified one witness, Patrick Barber. "But she acted like nothing was even going on."

George's conviction in January for drug distribution was part of a federal crackdown that is the largest investigation of prescription drug abuse in U.S. history. Since 2002, the U.S. attorney's office in Alexandria has convicted 170 people of selling, prescribing or ingesting painkillers, with 10 more scheduled to plead guilty in coming weeks.

The investigation, dubbed Operation Cotton Candy, has snared seven doctors, 11 nurses and a county prosecutor. One doctor pleaded guilty to demanding sex for drugs; a nurse shot up Dilaudid outside an emergency room. Another defendant burned down her flower shop to get insurance proceeds for pills.

Yet for all the effort, prescription drug abuse continues to worsen in Northern Virginia and throughout the Washington region as demand for painkillers rises among teenagers and others, according to federal and local investigators.

"We're seeing remarkable increases in Percocets sold on the street, a tremendous increase in Vicodin. Oxy is off the charts," said Loudoun County Sheriff's Deputy Cuno Andersen, a member of the Cotton Candy task force.

The investigation has been criticized by patient advocates, who say Cotton Candy targets doctors prescribing legal drugs to people in chronic pain. Some question whether the eight-year probe -- which has involved more than 50 prosecutors and employs 15 to 20 full-time FBI and Drug Enforcement Administration agents and Northern Virginia police officers -- is worth the time.

"It's an enormous waste of government resources," said Ronald T. Libby, a University of North Florida political science professor and author of "The Criminalization of Medicine: America's War on Doctors." He argued that law enforcement "can't make a case for any kind of prescription drug epidemic."

Prosecutors strongly defend their work, saying they reacted to a growing problem and have taken millions of illicit pills off Northern Virginia streets, raising the black market price of the most powerful 80-milligram OxyContin pill from $40 a decade ago to $65 to $75 today. But officials cannot point to any evidence that prescription drugs are a bigger problem here than elsewhere.

Still, Northern Virginia has become the epicenter of the national crackdown on narcotic painkillers because it has an especially aggressive prosecutor's office. Among the most relentless in that office is Gene Rossi, a 21-year veteran who has overseen Cotton Candy through five U.S. attorneys.

"We're not aware of any prescription drugs investigation in other districts that begins to approach this level of scope and effort," said U.S. Attorney Neil H. MacBride. "We believe we've made a dent in the problem in this area. The word is out in the medical community."

The effort is getting stronger. The DEA's Washington division recently created a squad focusing on prescription drugs, and the Alexandria probe is intensifying its focus on new avenues: dealers who create phony prescriptions and who "doctor shop" to get pills from multiple physicians. George was involved in both.

'The Devil'

Peddling pain pills is highly profitable. Insurance plans pay out billions for prescription drugs, which dealers can sell at a huge markup with little physical risk or overhead. And they are dangerously addictive -- more so, users say, than street drugs such as heroin.

"You can't function without it, and you'll do literally anything you can to get it," said Robert Woodson, a recovered addict who made $30,000 to $60,000 a month selling OxyContin before being convicted in a Cotton Candy case in 2004. He calls the drug "the Devil."

Investigators say prescription painkillers are especially dangerous because increasing numbers of teenagers consider them cool -- and are not aware of how addictive they are.

"It's behind a medicine cabinet or a pharmacy counter, so kids believe it's safe," said Ava Cooper-Davis, special agent in charge of the DEA's Washington division, which covers the District, Maryland and Northern Virginia.

Although such drugs as Dilaudid had long been a concern, investigators say the problem escalated after OxyContin came on the market in 1996. Addicts were getting pills in Northern Virginia and selling them here and in southwestern Virginia, Kentucky and Tennessee, triggering an epidemic in Appalachia.

FBI and DEA agents approached prosecutors in Alexandria, and Cotton Candy was born.

The investigation initially focused on pharmacists and doctors, especially William E. Hurwitz, a nationally prominent McLean pain specialist. Prosecutors say his conviction for narcotics trafficking -- he prescribed 1,200 oxycodone pills a day to a single patient -- vastly reduced the supply of illicit painkillers.

With Hurwitz and other doctors unable to prescribe, prosecutors turned to what they call the new way to get pills: generating and filling phony prescriptions and deceiving multiple doctors into filling prescriptions for a single patient.

More than 30 states have monitoring programs to prevent doctor shopping. Virginia's program began statewide in 2006, but only 10 percent of the state's licensed doctors and pharmacists participate, and the database -- which contains detailed prescription information -- didn't go online until October.

George, the 47-year-old Fredericksburg grandmother, "is the avant garde of what the problem now is," said one federal law enforcement official, speaking on condition of anonymity because George will not be sentenced until April 23. She faces up to 20 years in prison.

An attorney for George, Charles Burnham, declined to comment.

'Just didn't look right'

The trail to George began with an alert pharmacist in Fauquier County who called Loudoun County's Andersen in September 2007 and said a prescription for OxyContin "just didn't look right," Andersen recalled. The deputy, a former Richmond EMS worker, realized it was fraudulent -- the doctor's phone number, supposedly in Richmond, was not a Richmond exchange.

The prescription was written for Cindy Carter, George's daughter.

Andersen called the FBI, and nine days later, agents raided Carter's Prince William County townhouse and the Stafford County home of Richard and Lisa Sindelar.

Investigators determined that the couple and Richard's brother, John Sindelar, were using a computer template to create fake prescriptions. They would type in a real doctor's name and DEA numbers and the name of a nonexistent clinic, the Virginia Pain Institute.

The phone number at the top was for a prepaid cellphone. If the pharmacy called with a question, the Sindelars would answer. The computers they used for the scheme, investigators said, included one at a public library and another at a Virginia unemployment office.

The Sindelars pleaded guilty in 2008 in U.S. District Court in Alexandria and are serving prison terms ranging from 20 months to five years.

An affidavit, signed by FBI Special Agent Andrew B. Lenhart and filed in court, said George acted as a street-level distributor for the Sindelars, buying the OxyContin and other pills generated by their phony prescriptions and selling them for a large profit.

She obtained other drugs from up to five doctors because of a back injury -- and sold them out of her one-story, single-family patio home, in the parking lots of a Target and a bank, and in the aisles of a Chantilly gun shop, according to court testimony and investigators.

"She was doing this for a long time and kind of stayed under the radar," one federal investigator said. "Her house was clean and well-kept, and she drove a Ford Focus. She looked like a regular person."

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