MANHATTAN (CN) — Barbara Castro broke into tears as she described sitting in the waiting room, sometimes overnight, for a dirty doctor to prescribe oxycodone. She didn’t need the pain medication for her health, but like many others who waited hours upon hours for access to the highly addictive drug, she was hooked.
The 48-year-old took the stand Friday in the federal trial of Laurence Doud, a former CEO charged with drug trafficking and lying to the U.S. Drug Enforcement Administration.
Prosecutors say Doud instructed employees at his company, Rochester Drug Cooperative, to ignore red flags from its pharmacy customers, including high amounts of opioid prescriptions and an unusual amount of patients paying in cash.
One of those customers was Old Town Pharmacy in Staten Island, where Castro filled sham prescriptions.
Wearing a white sweater, jeans and tall black boots in court Friday, Castro explained to the jury that she got her first prescription for Vicodin, which contains the opioid hydrocodone, for an infection in her underarm sweat glands. After she had two surgeries to treat the condition, her doctor stopped prescribing the pan medication. Castro started looking for new doctors.
“My body was looking for it,” she explained, “and I didn’t know why.”
Castro got clean in 2003 but it didn't stick. She visited several different doctors who prescribed oxycodone after little or no examination. One of them would collect money and put it in a sock, she recalled.
In 2007, she started visiting Dr. Carl Anderson, who told patients to arrive at his office around 9 or 10 p.m. Anderson would arrive around 2 p.m., but patients could wait until as late as 8 p.m. to see him.
Everyone at the office paid in cash. Castro said Anderson sometimes held group appointments with her and her brother or a friend.
“We were all there to obtain the same medication, and he said to just come in together,” she told prosecutors.
The prescriptions for 180 milligrams of oxycodone kept coming, despite Castro showing clear signs that she was struggling with substance abuse.
“You could clearly see the track marks on my arms,” Castro said through tears. “I was clearly impaired. I would nod out in the waiting room with my head between my legs, waiting to see the doctor.”
Chain pharmacies like Walgreens and CVS eventually stopped taking prescriptions from Anderson, who pleaded guilty in 2019 to writing medically unnecessary prescriptions for oxycodone.
Castro turned to dispensaries, including Old Town Pharmacy, where she would run into others who had spent the night in Anderson’s waiting room. The pharmacy didn’t take insurance, so just as they did at the doctor, patients paid cash.
The testimony wasn’t the first time jurors heard about Old Town.
Jessica Bouck, a former compliance employee at Rochester Drug, said the distributor’s records at one point showed the pharmacy was accepting 20% cash for one narcotic — twice the percentage that triggered concern for prescriptions overall — and distributing a high amount of a dose that’s “highly abused.”
Distributors are supposed to watch out for bad pharmacies and “pill mill” prescribers by tracking suspicious orders and reporting those customers to the DEA. Protocols at Rochester Drug looked good in writing, but in practice, Doud and other managers flouted those rules, employees testified.
In one email read aloud in court, former chief compliance officer William Pietruszewski wrote that Doud wanted to “keep going” with a pharmacy that raised employee concerns.
“And if anyone disagrees they’ll need to answer to him,” the email said. “Larry threatened me to be on board with this or I may not like the outcome.”
William Pietruszewski pleaded guilty to a narcotics conspiracy, defrauding the government and failure to report suspicious pharmacy orders. He is expected to testify against Doud during the expected three-week trial.
Rochester Drug itself entered a nonprosecution agreement with the government, as did Bouck, who was required to testify in court as part of the deal.
Prosecutors say Doud’s practice of ignoring red flags from bad pharmacies was driven by greed and contributed to the deadly opioid epidemic. Drug overdoses have killed nearly 1 million people since 1999, and opioids account for a significant and increasing percentage. In 2019, the figure was north of 70%, according to the Centers for Disease Control and Prevention.
In reality, the figures are probably higher, said Ruther Carter, a former DEA agent and the government’s first trial witness. Coroners don’t always catch overdoses, or may not list them as the cause of death.
Carter said it’s common for people abusing opioids to turn to heroin after filling or buying the prescription drugs becomes too expensive.
“These drugs are similar to heroin,” she said Tuesday during direct examination. “In fact, heroin is a semisynthetic opioid that’s made from the poppy plant, and so is oxycodone.”
Defense attorneys for Doud elicited testimony that the bulk of the company’s profits came from nonpharmaceuticals, and said Doud’s bonuses were tied to sales of noncontrolled substances — drugs like albuterol, used to treat asthma, and the cholesterol-lowering medication Lipitor.
On Friday, attorney Robert Gottlieb expressed sympathy for Castro, but pointed to the doctors who Castro said took advantage of her.
“I’m sorry you’ve had a very difficult, very difficult, number of years,” said Gottleib, of the firm Robert C. Gottlieb Associates.
Ending his brief cross-examination, which noted that Castro went to other pharmacies in addition to Old Town and had never met Doud or any other Rochester Drug employees, Gottlieb told Castro, “I hope you are well.”
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