The culmination of a 10-month drug investigation called "Operation Pill Poppers" was impressive: 74 identified suspects, 150 counts of doctor shopping, 55,006 pills with a $750,000 street value.
But by the end of Monday's six-hour roundup, staged at a closed Egg Platter restaurant in Pinellas Park, dozens of suspects remained at large. Pinellas County sheriff's deputies and St. Petersburg police arrested 11 that day, plus nine from the previous week.
The operation, announced to the public as it was happening, was designed partly to raise awareness of the growing prescription drug problem in the Tampa Bay area. But it also highlights how tricky it is to curb such crimes when the addiction is so powerful, the drugs aren't illegal and the law hasn't caught up with the problem.
"People don't understand the scope of it," said Pinellas sheriff's Capt. Robert Alfonso, who oversaw the investigation. "Now, because of a huge influx of addicts scamming the system, the pills are taking over everything."
Law enforcement agencies throughout Florida have been gradually shifting their focus from marijuana and cocaine to a completely different animal that bears little resemblance to traditional drug crimes. In the 10-month Pinellas investigation, detectives relied heavily on information from pharmacists and doctors.
There are no grow houses, guns or telltale stacks of cash when they make arrests, Alfonso said. Sometimes, there aren't even substantial amounts of pills to collect as evidence.
"A majority of these people are just regular folks," Alfonso said.
And deaths are climbing.
Just last month, three women and one man who were in the Pinellas drug court system died from prescription drug overdoses, said Shannon Loveday, who manages the drug court.
A 2008 St. Petersburg Times investigation found that prescription painkillers and anti-anxiety drugs kill about 500 people a year in the Tampa Bay area, triple the number killed by illegal drugs such as cocaine and heroin.
The Pinellas sheriff's division that handles prescription drug crimes has doubled from four detectives to eight, with two added supervisors. The hope, Alfonso said, is to prevent Pinellas from turning into Broward County, known as a magnet for out-of-state prescription drug buyers.
Because a statewide prescription computer system does not yet exist in Florida, as it does in several other states, doctor shopping and prescription fraud is rampant. Doctors still use handwritten paper prescriptions, which are easy to forge, and law enforcement agencies must primarily rely on pharmacists to report suspicious customers.
One trend Pinellas detectives found is a multi-tiered system in which one person prints fake doctor's prescriptions on a computer and has a recruiter find someone — often an addict or homeless person — willing to use his identification to fill the prescription at a pharmacy. When the pharmacy calls the number on the prescription to verify, someone will answer and pretend to be a doctor's receptionist, and the recruited customer gets the pills and brings them back to recruiter and computer forger, keeping some as payment.
Detectives have also seen cases where patients use a real doctor's prescription and wash off the writing, Alfonso said. Then they scribble their own prescriptions for oxycodone or hydrocodone, two of the most popular painkillers.
"If we can eliminate paper scripts, we can eliminate 70 percent of these cases," Alfonso said. "But doctors are reluctant to go to an electronic system."
And going after doctors or clinics is even trickier than nabbing people obtaining the pills, said Pinellas sheriff's Sgt. Tom Nestor.
"We are looking at clinics," he said. "But that involves a more long-term, strategic investigation."
Last year, Hillsborough County sheriff's detectives wrapped up a 10-month investigation called "Operation Bad Medicine" with more than 100 arrests. A doctor, two nurses and three medical assistants were among them.
After years of debate, the Legislature approved a bill last year creating a database to track prescription drug sales in an effort to curb doctor shopping and illegal drug trafficking. But the details of the monitoring program still need to be worked out before it is implemented.
Right now, Florida is the largest of 16 states without such a program.
Emily Nipps can be reached at firstname.lastname@example.org or (727) 893-8452.