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When chemists go bad: wave of drug store dealers caught pill pushing

Shortly after 1pm on a cool, overcast day in March 2015, Trent Nguyen, a 37-year-old gym owner, pulled up in his silver Nissan Navara around the corner from The Chemist Shop in Abbotsford Point in inner western Sydney.

The chemist in charge, Ethan Le, emerged from the pharmacy carrying a large cardboard box.

He opened the passenger door and placed the box inside the vehicle before returning to the pharmacy.

It was a routine that Le, then 33, had performed many times, sometimes weekly, over the previous two years. Neither man knew that this time police were watching.

Nguyen, also known as The Tao Nguyen, a computer science graduate, had been under investigation for over a year for the supply of prohibited drugs. And Le, a Sydney University pharmacy graduate from Sefton, it would emerge, was a source.

The box Le was carrying was packed with restricted drugs, including morphine, testosterone and clonazepam, that required a doctor’s prescription to be dispensed by a pharmacist. There were 12,100 tablets of clonazepam, 30 syringes of testosterone, 500 tablets of diazepam, 280 tablets of morphine and a cocktail of other restricted drugs.

Inside the pharmacy, Le had $8500 in cash, as payment for a previous deal, and two blank stolen prescription pads. Le later told police from Strike Force Finney he would have been paid $10,000 for the drugs found in the cardboard box.

Nguyen would be sentenced to three years and four months jail in 2017 on charges concerning dealing with the supply of prohibited drugs. Le would plead guilty and also receive an 18-month jail sentence to be served as an intensive correction order in the community, for drug supply and proceeds of crime matters.

And last month, Le had his pharmacy licence stripped for 18 months for failing to tell pharmacy regulators of his conviction.

The case is the latest in a string of incidents involving suburban pharmacists convicted or professionally reprimanded for offences including supply, possession and dealing with proceeds of crime.

The revelations are at odds with community perceptions of pharmacists who rate as the third most trusted profession in Australia, ranked only behind doctors and nurses.

Now a Herald investigation can reveal:

    • NSW Health authorities have referred 35 pharmacists to regulators in NSW since June 2016 to protect the public following complaints of professional misconduct linked to improper restricted drug supply.
    • 24 NSW pharmacists have had their drug dispensing authorities of prescription only drugs and drugs of addiction withdrawn in the same time frame.
    • There currently are 15 banned pharmacists in Australia, but the national health professionals’ regulator AHPRA could not say how many have dispensing restrictions.
    • Stolen or lost prescription pads have been bought and used by rogue chemists.
    • Authorities are troubled by private prescribing and dispensing of restricted drugs outside the Pharmaceutical Benefits Scheme, making them harder to track.

Bruce Battye, the director of NSW Health’s Pharmaceutical Regulatory Unit, told the Herald that “the levels of inappropriate dispensing by pharmacists or illegal dispensing we detect appears to have escalated a bit over the years”.

“It’s a reflection of the increase in trafficking in these drugs in the community where prescription opioids have now overtaken heroin as a drug of abuse,” he said.

The restricted prescription drugs coming to his office’s attention include benzodiazepines, anabolic steroids, other performance and image-enhancement drugs and weight-loss drugs, as well as drugs of addiction fentanyl, oxycodone, morphine, hydromorphone and methadone.

The money to be made along the supply chain on the black market is significant: a single patch of fentanyl, a synthetic opiate drug that is a powerful painkiller and tranquilliser, could cost a patient on a concession card as little as $3.80 under the taxpayer-sponsored Pharmaceutical Benefits Scheme. But on the black market a patch could fetch $100 and a packet up to $800, Mr Battye said.

Financial pressures for pharmacists play a huge part, he said. “Some succumb to that pressure.”

He is quick to add that there are many thousands of honest, hard-working chemists around Australia.

AHPRA says there were 373 complaints or concerns made about pharmacists in 2016-17, representing less than 2 per cent of the profession.

“The overwhelming majority of registered health practitioners provide safe, high-quality care,” AHPRA said in a statement.

The heavy regulation around restricted prescription drugs makes it difficult for organised crime to infiltrate, authorities say.

NSW Drug and Firearm Squad Commander Peter McErlain told the Herald: “Often these pharmacists pop up in other drug jobs that we’re doing and while we’re not investigating them per se they do pop up in other illicit drug investigations.

“The majority of pharmacists are law-abiding people, but there’s always a small percentage that want to profit from what they can give to organised crime.”

Volume of drugs

The volume of drugs that can be moved by rogue pharmacists before they are detected is staggering.

Shortly before Christmas, Guildford pharmacist Anthony Sadek was found to have engaged in unsatisfactory professional conduct for oversupplying opioids.

Evidence tendered to the NSW Civil and Administrative Tribunal show that in just a year the number of OxyContin tablets dispensed in his pharmacy jumped by more than 100 times. Most came from a prescriptions signed by a doctor named only as Dr BW and were filled by a single patient.

Records compiled by the Pharmaceutical Regulatory Unit of the NSW Ministry of Health show the growth in the numbers of drugs dispensed at his pharmacy, from just 120 tablets of OxyContin in 2008, to 840 tablets in 2009. During 2010 a single patient collected 14,000 OxyContin tablets on scripts issued in the name of Dr BW.

In 2011, the amount dispensed doubled to 31,000, before jumping to almost 52,000 in 2013. In the first 11 weeks of 2014, prior to regulatory intervention, 13,000 OxyContin tablets were dispensed by the pharmacy on scripts issued in the name of Dr BW.

It amounted to 143,884 OxyContin 80mg tablets prescribed by one doctor, the bulk of which were dispensed by Mr Sadek personally over a four-year period to a single person, who was presenting multiple scripts, multiple times per week, and paying cash amounts of up to $2000 at a time.

“Looking at the massive quantities of opioid involved, and the fact that the prescribed strength was an unvarying maximum strength on every occasion, it is apparent that, whatever view Mr Sadek had of Dr BW’s bona fides as a doctor, the possibility of misuse of these drugs was very significant, and increased exponentially over time,” the tribunal found.

The tribunal heard that the manner of prescription made them more difficult to detect. An expert witness detailed how using private scripts for opioids is a well-known method of avoiding detection – as the dispensings are therefore not monitored by the PBS. Mr Sadek said he saw nothing unusual in all of the scripts being private scripts because the quantities were higher than that supported by the PBS, which only funds scripts of 28 pills.

The tribunal found: “Taken together with the fact that there were never directions for use on the relevant scripts, and the practitioner never met with any of the purported patients to advise or question them about their usage, leads us to conclude that Mr Sadek had actual or constructive knowledge of the likely misuse of these drugs over a long period.”

Mr Battye from the NSW regulator said his office maintained a database that collected intelligence from the medical and pharmacy communities, and had inter-agency relationships with law enforcement.

If they got a tip then the regulator inquired into the prescribing of a particular doctor or dispensing of a pharmacist, Mr Battye said.

“We obtain their purchase records. People who want to abuse or traffic, they go for highest strengths, they won’t muck around with low strength, so we’ll go looking for the highest and if we find a large volume we will go to the pharmacy and find out where the drugs are going to.”

‘Pharmacy in his car’

Just last month, the courts handed an experienced pharmacist in the NSW Hunter Valley, Phillip Lawrence Slater, an 18-month good behaviour bond for supplying steroids to an Australian representative body builder in 2016.

The experienced chemist who had a stake in five pharmacies emerged as the subject of a strike force investigation that found a “pharmacy in his car”, while a raid at his home uncovered 70 different medications that he had taken from his pharmacies for personal use.

“He was helping himself to discarded drugs for recreational use,” the sentencing magistrate said.

When Slater negotiated the sale of steroids and medications associated with bodybuilding to a professional bodybuilder, police were listening.

And when they stopped Slater’s car in April 2016, they found 16 boxes containing 48 syringes of testosterone, 60 capsules of Phentermine, used for weight loss, drugs that block the growth of oestrogen and Melatonin.

“I’m just transporting some stock between my shops,” Slater told police. “I’m a pharmacist.”

Slater pleaded guilty to two counts of supplying a prohibited drug and one of failing to comply with the conditions of his licence.

In a case from March, a Queanbeyan pharmacist was banned from practising for 12 months for supplying friends with steroids and drugs of addiction after pleading guilty and being convicted of five charges of supply.

The NSW Civil and Administrative tribunal heard Nicholas James Fearon supplied himself and a number of other friends and associates drugs including steroids, weight-loss drugs, Xanax and sleeping pills.

He was arrested at Blooms the Chemist in Queanbeyan in November 2014 and subsequently pleaded guilty to supplying prescription drugs and possessing a prohibited drug.

The Health Care Complaints Commission alleged that on multiple occasions Fearon supplied patients with prescribed medication without a written prescription. Many of the drugs alleged to have been supplied by Fearon were anabolic steroids. Most of the drugs alleged to have been supplied were “restricted substances” or “drugs of addiction”.

Camouflaging illicit activities

Fearon’s modus operandi again highlighted loopholes that took time to detect.

He created patient records and a common characteristic was that rather than recording the name of a prescribing practitioner, the prescriber was listed as a local hospital in most cases.

He would record a hospital’s name rather than the name of a medical practitioner as regulations require, suggesting that Fearon was creating a sort of alibi for himself. The HCCC alleged he might be able to claim plausibly to the proprietors or any investigator that this was a clerical error but that, unfortunately, he was unable to recall the name of the prescribing doctor.

Unless a cross-check with the physical prescriptions kept at the pharmacy or the copy held by the alleged issuing practitioner was conducted, it would be impossible to contradict such a claim, they said.

The tribunal heard that Fearon’s plea of guilty to the criminal offences implied he had concocted this modus operandi to camouflage his illicit activities, raising questions in relation to other transactions in which Fearon is listed as the dispensing pharmacist and the prescriber is listed as a hospital rather than a doctor identified by name.

In the case of the Abbotsford Point pharmacist, Ethan Le purchased a prescription pad and used it to forge scripts. He knew Nguyen through family connections and they occasionally attended the same gym and he supplied Nguyen with precription drugs every couple of weeks, sometimes weekly.

In order to avoid detection, he kept account of the orders and worked on Wednesdays the day deliveries were made. He said he would put the wholesale amount of the drugs purchased for Nguyen through the pharmacy’s account and charge Nguyen a surplus in order to turn a profit.

He had no idea what Nguyen did with the drugs and he didn’t want to know. He suspected that Nguyen would sell the drugs to men attending his gym to treat pain. He used the money he earned to “buy things and spend on stupid stuff”. He estimated he made around $40,000 from the illegal trades over the two years.

Nguyen, the man Le supplied, was being surveilled because he had in turn been supplying Sydney chemical engineer Stjepan Puric, who would be jailed for seven years in 2016 for operating a large-scale commercial drug manufacture and supply business after he was caught importing camphor oil that could be used to make ecstasy tablets.

Mr Battye acknowedged his office had been “catching the low-hanging fruit” and fresh cases continue to emerge, with one matter concerning the illegal importation of steroids currently before the courts.

“We don’t kid ourselves that we’ve got everyone,” he said.

The Pharmacy Guild of Australia emphasises that it supports the full force of the law being brought to bear on any pharmacist who is proven to have abused their position as the custodian of powerful and addictive medicines. 

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