Almost three people die each day from an opioid overdose in Virginia.
An On Your Side investigation into Medicare data found hundreds of doctors around the country write excessive numbers of painkiller prescriptions. The data show 137 doctors wrote more prescriptions for opioids than the number of days in a year.
The Drug Enforcement Agency in Richmond opened its files to NBC12, showing its massive effort in Virginia to keep the doctors, dentists, hospitals and pharmacies in line.
One little pill can start an addiction so fierce even medical professionals are not immune because the money that can be made is too enticing.
"In Central Virginia and Southwest Virginia, across the country, we are finding unscrupulous doctors writing prescriptions outside the scope of medical practice,” said Special Agent Mike Barbuti, who is in charge of the Richmond District Office for the Drug Enforcement Agency (DEA).
Law enforcement is fighting the opioid epidemic on all fronts, from forged and altered prescriptions to doctors stealing drugs to feed their own addictions.
Agents caught a pharmacist in Southwest Virginia who had developed an addiction. They said he was injecting himself with a drug used for severe pain and the terminally ill and then replacing the vials with saline or water and giving that to the patient instead of the medication.
The DEA found evidence of a Richmond area doctor at a private practice writing bad prescriptions. It also is investigating a nurse at a Richmond area hospital who was caught tampering with bottles of the powerful painkiller hydromorphone.
Officials said she glued the top back on so another nurse giving the drug to a patient wouldn't know it had been opened.
The DEA is also tracking shipments of opioids, like one to Virginia Beach in which the box was clearly tampered with. That includes counterfeit painkillers being shipped from overseas.
"The opioid epidemic is the worst drug crisis I've seen in my over 25 years with the DEA," said Barbuti, who is overseeing a new task force in Central Virginia called the tactical diversion squad. It was formed specifically to tackle the opioid crisis head on. "We're seeing it in rural areas, suburban areas, urban areas - people from all walks of life, all ages, all professions. It doesn't discriminate, and the prescription pill addiction is the leading cause of that."
Some of the toughest investigations focus on licensed doctors dispensing drugs without a legitimate medical purpose, known as "pill mills."
"In our eyes, a doctor dealing drugs is no different than a drug dealer in a white coat," said Ruth Carter, the diversion program manager for Washington Division of the DEA.
And what she said is exactly what the U.S. attorney's office told Dr. Clarence Scranage Jr at his sentencing hearing. Scranage flooded the underground drug market with addictive pain pills.
Over a four-year period Scranage wrote 1,257 prescriptions, often for people he never saw, and 223,140 oxycodone pills in exchange for money. That amounts to 153 pills a day potentially hitting Richmond's black market.
"He definitely put lives at risk," Carter said. "All of these drugs put lives at risk."
Prosecutors say Scranage made $628,500 on the scheme at his offices in Richmond, Chesterfield, Henrico and Petersburg. He maintains his innocence and is appealing his 30-year prison sentence.
Scranage is not alone. Dozens of cases from the FBI, DEA, U.S. Attorney and State Police involve doctors, dentists and pharmacists across Virginia.
Carter says the DEA tackles the crisis in many ways.
"We regulate the registrants, the doctors, pharmacies, hospitals," Carter said. "Anyone who handles controlled substances in the U.S. has to be registered with DEA. In 2016, more people died from drug overdoses then they did in the Vietnam War. That’s pretty significant."
The percentage of bad actors is less than 1 percent, but there are almost 1.7 million registered doctors in the U.S.
"We’ve increased our regulatory approach, increased investigations where we go on-site," Carter said. "We look at their drugs. We, a lot of times, conduct audits. We insure they can account for their drugs. We’ve increased our presence. The community, the faith-based communities, community groups, everyone should be paying attention to this, because it effects everyone."
"We're here to try and protect the public and try and make sure that legitimate doctors are able to prescribe the medicine that they need for their patients," Barbuti. said.
The DEA encourages anyone who knows of a doctor writing suspicious prescriptions to report it.
There is also a drug takeback April 28 where any expired or unwanted painkillers can be returned.
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