Pharmacists Under the Gun

Pharmacists need special protection because they take special risks

The fact is this: burglary, armed robbery and the potential violence which accompany both are the number one concern of many of the nation's pharmacists. It is difficult to find a community pharmacist who has not yet suffered an actual or attempted break-in or armed robbery. In urban centers of the country, pharmacy theft is a well-established fact of life. "I've got members in Pittsburgh who practice every day with guns strapped on their thighs," said Arnon Lear, executive director of the Pennsylvania Pharmaceutical Association. The spectre of pharmacy curriculums offering courses in the use of firearms as a prerequisite for a degree is, of course, a ludicrous proposition. But pharmacists across the country are arming themselves; or simply refusing to stock many controlled substances. Who could blame them? In 1974, for example, more pharmacists than policemen were killed in New York City. The recent experience of a patient and his son in a Manhattan pharmacy .reveals the extent to which the problem of theft has affected the practice of pharmacy. The father tells his story like thisThe pharmacist behind the counter looked at us suspiciously. It was late, after all, and the streets were deserted. He was alone in the store, and my son must have resembled a reject from a hippy colony. Leather jacket. Riding boots. The works. He was at that age. My son suffers from terrible migraine headaches. He had a prescription for medication, but hadn't taken the time to get it filled. I said good evening from the front door as we walked to the rear of the store. My son reached for the prescription in his pocket and the pharmacist reached for the gun on

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his hip. We hadn't seen that before and we both tried to scream, run, duck and pray at the same time. We were terrified. Fortunately, the father recalled, the crisis passed when the pharmacist recognized the son was fishing out a prescription order, not a weapon. Suddenly he was once more their friendly community pharmacist, ready to fill a prescription. The New York City practitioner did explain the gun to his still-shaking patients. He said he had been robbed six times in the last 17 months, once through the roof and twice through the wall, and twice more at gunpoint. "What else can I do?" he asked. What indeed. The problem certainly is not pharmacists who carry guns, but the very real threat of robbery and the fact that the pharmacist is extremely vulnerable. Not just in New York City, but in more "civilized" communities like Austin, Texas, and Bowie, Maryland. (see story, below). Across the nation, the profession of pharmacy is under the gun.

One Pharmacist's Story Pharmacist Neal Jacobs is hopping mad. He believes society expects a great deal from him and offers very little in return. A practicing pharmacist in Bowie, Maryland, a suburb of thf] nation's capitol, APhA member Jacobs figures he has struck a very uneven bargain with society. For his part, Jacobs dispenses lifesa ving medica tions the community expects . him to stock. In return, however, nobody seems particularly interested in protecting him against the criminals who have victimized him on seven separate nights. The violators of his Belair Professional Pharmacy have displayed extraordinary imagination. Twice they have come through the roof, sledge-hammering their way unnoticed through half the night. On other occasions they ha ve bored holes through a steel door to remove a lock; torn off a steel door in the rear of the pharmacy; and removed his burglar alarm system. On only one occasion have the local police been able to apprehend the burglars-they were found shooting up Demerol while bagging the Seconal they had stolen for sale on the street. "Do you know what it feels like, " Jacobs asks, "to walk into the pharmacy every morning and not know whether you've been broken into?" He tries to explain, gets angry in the process, and ends up talking about the

Pharmacy theft in the United States has become a $500 million-a-year business, a business sometimes conducted by professionals but more often than not the specialty of amateurs who have watched too many detective flicks and know a bag of five Seconal capsules can bring as much as $25 on the street. However you analyze it, pharmacists are the unwitting brokers of the dangerous and often violent marriage of drug abuse and crime. Worse, it is a marriage with equally dangerous offspring. For every apparently isolated case of pharmacy theft, there is the potential for at least one more person becoming strung out on drugs. In that potential is the seed for further crime. Perhaps the numbers will impress you. In fiscal 1973, there were 4,333 reported pharmacy thefts; in fiscal 1974, there were 6,320 thefts with almost 30 million total dosage units stolen. For the year ended last July, the government is projecting more than 7,000 pharmacy thefts. Fifteen to 20 percent of them will be violent.

local police department. Ever since he was first burglarized in 1972, Jacobs has conducted a running battle with local police authorities in an effort to make them understand the uniquely vulnerable position of the community pharmacist. He has taken his complaints to the Bowie City Council, where among other things, he charged that one policeman who was supposed to patrol his pharmacy and other area businesses spent more time relaxing in his police cruiser talking to his girl friend. When Jacobs subsequently lost his handgun permit on what he alleges were trumped-up charges, he asked that a policeman accompany him every evening when he carried his daily receipts to his car. The police department has refused, claiming it lacked manpower necessary to provide Jacobs such "special" protection. Without his handgun, or adequate police protection, Jacobs considers himself "a sitting duck." Ironically enough, pharmacist Jacobs has invited some of his own problems. Unlike several of the pharmacies in his area-including a major chain-he insists on carrying products like Dilaudid and injectible Demerol, a policy whose significance isn't lost on the community's criminal element. For Jacobs, however, not to carry such products would betray both his training and

Journal of the American Pharmaceutical Association

As impressive as they are, the statistics understate the case for several reasons. First, the government uses them to pass the buck . According to the Drug Enforcement Administration (DEAl. the incidence of pharmacy theft is no higher than that for other businessmen . " That is a lot of baloney, " said Pennsylvania 's Lear. " The fact is that pharmacies and liquor stores suffer a disproportionate share of burglaries and armed robberies ." Sal Rubino, executive director of the Pharmaceutical Society of the State of New York , reports an interesting and alarming statistic. According to Rubino, in 1973 there were 424 pharmacy robberies in New York City, the nation 's financial center. There were 339 bank robberies. The statistics also disguise the multiplier effect of pharmacy theft-the victimization of young people and their inevitable susceptibility to crime . When a grocery store is burglarized, the owner must pay for the damage and the missing merchandise.

When a pharmacy is hit, the pharmacist must do the same and society must pay the incalculable costs of drug abuse , the crime it inspires, and the lives it destroys. Moreover, the statistics fail to account for professional responsibility and for society's expectations . The community pharmacist believes he has a responsibility to the health of his patients. So do they. Grocers, furniture store owners and dry cleaners-they are not vital to the public health. A patient with cancer will suffer no pain without a loaf of bread, a new easy chair or a freshly pressed shirt. But he will suffer acute pain without Dilaudid. And his pharmacist may risk his life by stocking it. In short, the data do not say this-pharmacists deserve special protection because the society expects them to take special risks . Another problem with the statistics is their impersonality. Statistics don 't victimize pharmacists. Criminals do. Their victims are people with their professional lives invested in their pharmacies. They are

his professional responsibility . " I put my life on the line to carry these products, " he told the Journal. " But people with cancer-people with pain- need relief and depend on me to provide it. Try telling a man whose wife is suffering incredible pain that you don 't carry the prescribed medication and don 't know where he can get it. " Like many practicing pharmacists, Jacobs favors making pharmacy theft a federal offense subject to stiff prison terms. He laughs at claims by the Drug Enforcement Administration that pharmacies are no worse off than many small businessmen who are the steady prey of criminals. " That 's just incredible nonsense. Show me another businessman who has something besides money people are willing to kill for. The florist next door to me has been there 10 years and has never been hit. " If pharmacy theft was a federal offense, Jacobs believes, protection would be more professional and more consistent; and, he said, the very fact the FBI would investigate such thefts would in itself serve as a deterrent. The media could also help, says Jacobs. " All you ever hear about are bank robberies . SOCiety attaches greater importance to a missing $20 bill than it does to the multiplication of crime and drug abuse that occurs when somebody robs

me and sells what he steals to the young kids in the community. " Whatever the jurisdictional status of pharmacy theft, make no mistake about it. Neal Jacobs wants-demands-better protection. "/'m entitled to it, " he said. " I am licensed by the government and if it and society entrust me with the responsibility to dispense life-saving medications, they ought to protect me for doing it. " In the meantime, Jacobs continues his practice, where his patients routinely consult him on the use of their medications; where his use of patient medication profiles prevents possible adverse reactions; where he asks his patients to have their physiCians prescribe generically; and where he can take a patient 's blood pressure at a small table just across from the prescription counter. Unfortunately, his pharmacy is also a place where Jacobs feels the daily threat of armed robbery or burglary. Since men are mortal, they tend to think of a threatening situation in terms of its most extreme consequence. The man behind the prescription counter in Bowie, Maryland, knows that a dead Neal Jacobs is not beyond the realm of possibility. So it can hardly be unexpected that after seven incidents in little more than two years, what Neal Jacobs wants more than anything else is peace of mind. It 's not that much to ask . •

Vol. NS 15. No. 10. October 1975

people with families; people with aspirations and fears no statistics could reveal. " It's one thing for you to walk into your place in the morning to find you 've been robbed of drugs and merchandise," says APhA President Kenneth E. Tiemann. " It's quite another to stare down the barrel of a gun." Tiemann 's community pharmacies in Austin , Texas, have been broken into 14 times despite the use of silent alarm systems, closed circuit monitoring, and other security devices. As Tiemann knows only too well, pharmacy theft is a matter of minutes, so that even the best security systems often prove of little use. Since 1973, APhA and other national pharmacy organizations have been working with DEA on the problem that plagues Tiemann and thousands of pharmacists . Since the inception of the meetings, DEA has worked from the premise that making pharmacy theft a federal crime is a bad idea. In the interim, the profession has been successful in persuading several congressmen to introduce legislation changing the status of pharmacy theft. At present, APhA supports legislation introduced by Sen . Birch Bayh (D-Ind.) and Rep . Robert Nix (D-Pa.). But they have introduced bills before and they have failed , largely because DEA has indicated no interest in enforcing such legislation . In a recent speech before a security conference of the National Association of Chain Drug Stores, the DEA position was made quite clear by Kenneth A. Durrin, chief of the agency's compliance investigations division. " Even if the pharmacist succeeds in getting a federal law, and this is by no means certain, the problem is still there. The pharmacist is expending precious time both in promoting and awaiting the passage of federal legislation. Meantime, the thefts continue unabated. " I am not suggesting that federal laws are inappropriate for many crimes," continued Durrin, " but I do firmly believe that federal coverage is totally unsuited to crimes against drug stores and similar small businesses because of the nature of these crimes." If Durrin is unoptimistic, his attitude is indicative of the pervasive pessimism which infects most attitudes about crime in general. Since 1960, the number of robberies has more than tripled . The murder rate has doubled with handguns almost as common (Continued on page 551) 549

More than

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Pharmacists Under the Gun (Continued from page 549) as amphetamines. Every facet of the nation's law enforcement system is under attack-the police for ineffectiveness, the courts for permissiveness, the prisons for their utter failure to rehabilitate. Criminologists, penologists and other experts have expressed increasing doubt that anything can be done to stem the incidence of crime. In the last decade, the federal government has spent $4 billion, and politicians considerable rhetoric, in an attempt to reduce crime. Both have failed miserably. The net effect of their failure is a virtual public surrender to crime and disappearance of confidence that crime can be licked. And so the question of how to solve the problem of pharmacy theft is part of a much larger problem-how to arouse public indignation and community action when so many regard crime only as one of the newest of life's many burdens. DEA has had some success in St. Louis with Operation Pharmacy Theft Protection (PTP). The DEA pilot project focused on stepped-up police patrols of pharmacies; minimal stocking of controlled substances and wholesaler support for the practice disposal of inventories; use of undercover informants, and DEA-provided training and technical assistance in security methods. The first quarter results of Operation PTP project a 1975 decline of 38.4 percent in robberies and a 59.1 percent decline in burglaries. It is still unclear, however, whether substantial reductions in crime were achieved or whether Operation PTP dispersed pharmacy thefts to outlying suburban areas. Even with the reported declines in St. Louis, three persons were killed during the data-gathering stage of Operation PTP. And DEA has said it will fund no further programs, but will be available to provide assistance to communities which want to institute PTP-type programs of their own. Short of the comprehensive effort in the PTP program, DEA advises that pharmacists take security measures that require comparatively large capital expenditures and would make their places of practice nothing less than impregnable fortresses. And perhaps that is what it takes. For while the profession and others can throw the engines of rhetoric into high gear, those hoping for a definitive answer to the mounting problem of pharmacy theft will be sorely disappointed. There is no single answer. And that fact is the most disturbing statistic of all. ' . Vol. NS 15, No. 10, October 1975

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Pharmacists under the gun.

Pharmacists Under the Gun Pharmacists need special protection because they take special risks The fact is this: burglary, armed robbery and the pote...
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