While searching the internet for interesting pharmacy topics to post on Twitter, I wasn’t shocked to find that there had been another drugstore robbery until I noticed that this time there had been four people shot and killed. Execution style.
Sunday morning, June 17, a man wearing a baseball hat and sunglasses walked into Haven Drugs in Medford, Long Island armed with a handgun. He shot and killed everyone who was in the store at the time – the pharmacist, a teenaged employee and two very unlucky customers. Then
he took off on foot with prescription drugs, leaving the cash register untouched. Also unsurprising were the kind of drugs he stole: hydrocodone, the main ingredient in Vicodin – more than 11,000 pills worth. Along with that stash he stole “unspecified amounts” of two other medications, promethezine and cheratussin.
According to the New York Times, more than 1,800 pharmacy robberies have taken place in the US over the last three years. Most of the robbers have been young men addicted to opioid painkillers and looking for drugs to sell or feed their own addictions. The most popular drugs stolen are oxycodone, the main ingredient in OxyContin, hydrocodone and Xanax (popular for recreational use because of its mellowing effects, or for coming down off stimulants like methamphetamine.) I presume the Long Island robber grabbed promethezine and cheratussin so he could go home and relax with a nice glass of Purple Drank: mix prometh with the cheratussin (a purple cough syrup containing codeine), add Sprite or Mountain Dew, a couple pieces of Jolly Rancher candy (watermelon flavor is the best!), a little ice and enjoy! Or, as the hip-hoppers might say, “Take that S**T and put it in a cup with sprite, add a jolly rancher, sip it, spark a bleezy and you’ll be leanin’. Walk up in the club, high as hell cuz we full of drugs.”
The question now is how did we get here? Every pharmacist in the country is probably wondering, “Will I be next? “What can be done about this?” We tend to treat symptoms in America. When a problem comes up we don’t give too much thought to the cause. A suspect has already been arrested in the Long Island case and he will be dealt with. The current attitude toward crime and criminals is one of no tolerance. Quick justice. Stiff penalties. This guy killed four people and he ought to go to jail. No argument here. Yet if long sentences, more prisons and the death penalty were true deterrents to crime, we would surely be a crime-free society. The International Centre for Prison Studies at King’s College in London lists America as having the largest documented prison population in the world. We have about 2 million people behind bars, or 701 per 100,000. Only North Korea imprisons more of its citizens per capita than we do – an estimated 900 per 100,000. Terrific. The only country that locks up more of their own people than we do is a notorious, authoritarian state. Despite what you might think, crime here isn’t worse than other places. The US Department of Justice reports that rates of burglary, assault and car theft are actually higher in Britain – so what gives?
Government solutions to drug trafficking and abuse just aren’t working, no matter how much money we throw at the problems or how many jails we build. Sick and tired of violence and drug addicts, individuals look for solutions. Many pharmacists work behind bullet proof glass. Some carry handguns and use them, like at the Reliable Discount Pharmacy in Oklahoma City in 2009. We’ll see more of this – vigilante justice is very
trendy at the moment. Still others hire full time security guards. The move towards mail order pharmacy will speed up because it can be justified as a safer alternative to personal service. All of these reactions to violent crime are understandable in the context of the personal. If I were a pharmacist, a working stiff with a family, and I were worried that some punk, high on drugs, might come along with a gun and try to steal my wares, I might do the same things. But from a larger perspective, if more guns could prevent crime, America, again, would be crime-free. The World Health Organization reported a total of 29,771 firearm deaths in America in 2003, compared to 7,653 in 22 other high income countries like Australia, Canada, Norway and the UK. Our total population, by the way, was 290.8 million vs. 563.5 million combined in the other countries.
No doubt bullet proof glass and guns and mail order service could make the individual pharmacist safer. Yet pharmacists are seeking to expand their role as drug educators and counselors through Medical Therapy Management (MTM). MTM is conducted between patient and pharmacist, preferably in person and face-to-face in order to enhance trust and intimacy. But fear of violence in the workplace and the current ways of coping with it build a wall between pharmacists and patients which will, over the long haul, take a terrible toll on the profession.
Maybe the model for patient assessment and purchase of prescription drugs will have to change from the retail outlet to something else. But even that is not a long term solution. The root causes of drug addiction and crime are not completely understood or agreed upon. They’re not even part of our national conversation; we just want them to go away. Ever increasing poverty, mental illness, ignorance and disaffection are poisoning
American society; violence and addiction sicken and sadden and anger us but do not inspire us to any effective action. While we continue to voice our outrage and tighten the screws by isolating pharmacists and stiffening penalties, the criminals will go on about their business – ever more brazen and desperate.