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By Jill King Greenwood
Thursday, June 9, 2011

The dismantling of an elaborate prescription painkiller distribution ring merely "opened the front" in the war on illegal pills in Western Pennsylvania, a crime that is growing here and nationwide, U.S. Attorney David J. Hickton said on Wednesday.

Agents arrested 15 people in predawn raids in South Hills communities and other parts of Allegheny County, culminating a two-year investigation into the region's "largest, most sophisticated" prescription drug ring, authorities said.

A federal grand jury indicted 19 people in the ring, which utilized homemade and stolen doctors' prescription notepads, fake driver's licenses, doctor identification numbers from the U.S. Drug Enforcement Agency and a computer template tracking transactions and participants, investigators said.

"The days of someone standing on a street corner selling pills is over," said Gary M. Davis, assistant special agent in charge of the DEA's Pittsburgh field office. "This operation was very organized, and very sophisticated."

Authorities identified the ringleader as John Paul Larcinese, 31, of Jefferson Hills, whose brother, Philip Larcinese III, is an investigator with the state Attorney General's Office and whose mother, Mary Larcinese, is the borough's former mayor.

Although the prescription pads bore legitimate doctors' names and DEA numbers, the suspects would replace phone numbers for doctors' offices with those of cell phones they carried, so that a pharmacist calling to verify a prescription would reach them.

The suspects drove drug runners to pharmacies, fraudulent prescriptions in hand, and told them who to ask for and what to say to ensure prescriptions were filled. They were given money or drugs in exchange for serving as runners, Hickton said.

The ring obtained 1,645,000 tablets of oxycodone, Hickton said. A 30-milligram tablet sells on the street for $30, he said, although not all the tablets were that size. Authorities estimate the ring distributed more than $1.6 million worth of OxyContin, oxycodone and hydrocodone.

Prescribed as a painkiller, oxycodone is an opiate analgesic that can be addictive, according to the National Institutes of Health. It works by changing the way the brain and nervous system respond to pain.

"When abused, these pills are as wicked as a stamp bag of heroin," Hickton said.

Authorities say prescription drug abuse is spreading nationwide and illegal trafficking of prescription drugs is becoming a billion dollar industry. Prescription drugs surpassed marijuana as the gateway drug for first-time drug abusers in the United States about two years ago, said Rusty Payne, a spokesman for the DEA.

In 2009, an estimated 7 million Americans were abusing prescription pain and anxiety drugs, up 13 percent from the prior year, according to the DEA.

"It's a significant shift in trend," Payne said.

Between 1990 and 2006, prescriptions for painkillers nationwide increased tenfold, according to the Centers for Disease Control and Prevention. Illegal trafficking of prescription drugs is becoming a billion dollar industry, authorities said.

A Tribune-Review special report last summer examined Allegheny County Medical Examiner's records from 2006 through 2008 and found that accidental drug overdoses killed about 650 people in that period, more than homicides and car crashes combined. Two out of three of those deaths involved at least one prescription drug. Oxycodone ranked second on the list of most-common painkillers that toxicologists found in those cases, trailing only methadone.

Fatal overdoses in Allegheny County have quadrupled since the 1980s, when the county averaged 58 a year. Drug deaths topped 100 for the first time in 1998; four years later, the figure doubled to more than 200 annually. It has not dropped below since.

The investigation began after the arrest last June of Larcinese for passing fraudulent prescriptions for oxycodone in Mt. Lebanon, said Mt. Lebanon police Chief Coleman McDonough. "It all began to unravel from there," McDonough said.

Larcinese pleaded guilty in March in federal court to charges of conspiracy to possess and distribute oxycodone, police said.

All but four of the 19 suspects live in suburban Pittsburgh communities. One is from Washington County.

Dr. Neil Capretto, director of Gateway Rehabilitation Services, said he's not surprised the ring operated largely outside the city's limits. Capretto said Gateway expanded its detox unit about two months ago, in large part because of the number of people addicted to opiates and painkillers. It regularly admits up to 10 people a day for those addictions, he said.

"The problem of prescription drug abuse has never been worse than it is now, and there isn't a neighborhood in our area or any section of the country not affected by it," Capretto said. "It's a plague, and those dealing in this are getting smarter and more sophisticated."

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