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The information provided in the previous section is only a generalized description of pharmacy
robbery. You must combine the basic facts with a more specific understanding of your local problem. Analyzing the local problem carefully will help you design a more effective response strategy.
The following groups have an interest in the pharmacy robbery problem and ought to be considered for the contribution they might make to gathering information about the problem and responding to it:
In addition to the above, other key stakeholders are drug-free community coalitions, pharmaceutical companies, and a variety of state and Federal Government agencies, such as pharmaceutical and medical licensing boards and public health agencies.
The following are some critical questions you should ask in analyzing your particular problem of
pharmacy robbery, even if the answers are not always readily available. Your answers to these and
other questions will help you choose the most appropriate set of responses later on.
† See Problem-Solving Tools Guide No. 3, Using Offender Interviews to Inform Police Problem Solving, for further information.
The details behind past incidents of pharmacy robberies are likely captured in crime incident reports and investigative records. But understanding the larger context of pharmacy robberies requires obtaining data on supply and demand of prescription drugs on both the legal and illegal markets. Several national data-collection efforts provide state- and regional-level information on trends and patterns in substance use disorders, including misuse of prescription drugs. For example, the DEA’s Theft Database collects data on pharmacy thefts.
However, participation in this database is voluntary; the resulting incomplete reporting limits the database’s utility. Understanding these patterns can help alert police to the emergence of new trends in commonly abused prescription drugs. They can also inform pharmacies on the types of drugs that are most sought after, guiding decisions on restricting the sales and availability of such drugs (and widely publicizing those restrictions) in order to prevent robberies.
Sponsored by the National Institute on Drug Abuse, the Community Epidemiology Working Group (CEWG) was a consortium of more than 20 researchers from major metropolitan areas who met annually to report on local drug abuse patterns and trends. It was replaced in August 2014 with the National Drug Early Warning System (NDEWS), which builds upon and expands the former program by broadening the network, including national perspectives and innovative identification and monitoring approaches, and reporting on new trends and issues that arise nationwide. Local police agencies can consult the group’s website at www.drugabuse.gov/related-topics/trends-statistics/national-drug-
The Arrestee Drug Abuse Monitoring (ADAM) program collected data through drug tests and self-reported drug use of adult male arrestees in 10 U.S. counties from 2007 through 2011 and in 5 counties in 2012 and 2013; the program was discontinued in 2013. ADAM data were particularly useful to local police in identifying shifts in local trends in illicit drug use, including the nonmedical use of prescription drugs. Annual reports of ADAM data can be found on the Office of National Drug Control Policy’s website. In addition, some other metropolitan areas (e.g., San Diego County through the San Diego Association of Governments) are collecting their own ADAM-type data.
The Treatment Episode Data Set, supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), reports admissions to specialty treatment facilities by state and primary abused substance, enabling local police to identify statewide trends over time. The data set’s website has a search engine enabling users to select data by year and state.
The Drug Abuse Warning Network (DAWN) reported data on drug-related emergency department (ED) visits and drug-related deaths reported by medical examiners (ME). The ED visit data was nationally representative and for a small number of selected metropolitan areas; the ME data was available for some states and selected metropolitan areas. The DAWN system was discontinued in 2011; currently SAMHSA is working with the National Center for Health Statistics to implement a new system for collecting drug-related data in EDs. Drug-involved death data, including those involving prescription medications are available from the Centers for Disease Control and Prevention mortality files.
The Monitoring the Future (MTF) study and the National Survey on Drug Use and Health (NSDUH) are both excellent sources for examining trends in substance use and related issues among youth and the general U.S. household population , respectively. The MTF collects data on drug use and related attitudes and behaviors among 8th, 10th, and 12th grade students; the survey is nationally representative and can provide estimates by region, but the sample cannot support state-level estimates. The NSDUH collects data on drug use, treatment need and receipt, initiation, and attitudes and beliefs on Americans 12 and older living in households and other group quarters. The data are nationally representative; estimates also are provided by state for many of the variables.
Most states have implemented prescription drug monitoring programs (referred to as PMP or PDMP). These programs are databases that provide information to health care providers on what prescriptions individuals are receiving. Law enforcement may be able to obtain the identified data to spot a trend; check with your state PDMP administrator. In most states, law enforcement must have a subpoena to obtain specific data. PMPs document all retail sales of certain prescription drugs. Depending upon the law in your state, police can analyze this data to identify unusual sales volumes by retailer, healthcare provider, and drug type. You may contact your state data collection entities to gain access to the data, which can illustrate the types of prescription drugs that are dispensed, the degree to which certain medical prescribers appear to be overprescribing, and other statewide patterns of potential misuse and diversion. This information is useful, as the demand for these drugs may soon be followed by increases in robberies to acquire it. Understanding the illicit demand for specific drugs can help police and pharmacists anticipate and prevent robberies to get those drugs.
The sources mentioned previously are limited to data at the state or metropolitan area level, but they may not tell the local story. Police agencies tackling the problem of pharmacy robbery can create their own data collection tools in order to capture the true local context and underlying causes of the problem. The Reno (Nevada) Police Department, for example, conducted surveys of area pharmacists and doctors and also reviewed and revised the way the department coded reported incidents of prescription drug related crimes to enable the agency to isolate those cases from other drug-related crimes.16 Another source of local data may be the Coroner or Medical Examiner’s Office, which tracks overdoses.
A key question you should ask is to what degree can your agency effectively track the types of prescription drugs that are associated with robberies, burglaries, and other criminal acts? Is this information only available through a manual search and count? If so, it will be critical in the long term to create new sources of data rather than adjusting current reporting in order to be effective. Ultimately, agencies will need to stop building one-off data collection methods and instead strive to develop an accurate and comprehensive database that can be shared across agencies and jurisdictions.
The analyses referenced above will aid you in identifying appropriate responses to your pharmacy robbery problem (a description of possible responses appears later in this guide). Once a response (or series of responses) is implemented, it will be critical to measure its effectiveness. Measurement allows you to determine to what degree your efforts have succeeded and suggests how you might modify your responses if they are not producing the intended results.
You should take measures of your problem before you implement responses to determine how serious the problem is and, after you implement them, to determine whether they have been effective. All measures should be taken in both the target area and the surrounding area. For more detailed guidance on measuring effectiveness, see Problem-Solving Tools Guide No. 1, Assessing Responses to Problems: An Introductory Guide for Police Problem-Solvers and Problem-Solving Tools Guide No. 10, Analyzing Crime Displacement and Diffusion.
The following are potentially useful measures of the effectiveness of responses to pharmacy robbery. Process measures show the extent to which responses were properly implemented. Outcome measures show the extent to which the responses reduced the level or severity of the problem.
It is important to remember that some of these measures may be misleading depending on the types of responses your department applies to the problem. For example, if your agency partners with pharmacies to institute better target-hardening measures to reduce robberies, and those robberies decline but other forms of diversion such as prescription-drug fraud increase, the harms associated with robbery may be reduced, but the larger problem of prescription-drug diversion remains. This underscores the importance of tackling the problem of pharmacy robbery within the larger context of prescription drug diversion and misuse. But regardless, reducing pharmacy robberies is a notable end goal in and of itself, as these crimes pose substantial danger to employees, customers, and responding officers.