The pills on Joe Yousem's shelf sell for a fancy price on the streets of Baltimore, but he's no narcotics dealer.
Yousem has been a respected pharmacist for 36 years. But for a drug abuser, a Percocet tablet is a Percocet tablet, whether it comes from a pharmacist or a street-corner pusher.
"These people are pretty clever about getting what they want," says Yousem, who screens prescriptions at the Wilde Lake Pharmacy in Columbia.
"You never know who might forge one. It could be an elderly woman or it could be someone pretending to be a cancer patient."
The drugs commonly targeted by the prescription forgers -- including Dilaudid, a methadone substitute that sells for up to $40 a tablet on the street -- are the reason county police Detective David J. Trapani is beginning a new beat.
Trapani began Aug. 20 as the county's first full-time pharmaceutical drug detective, a position created in light of more than 300 reported prescription forgeries last year.
"I've already been getting about three calls a day and I expect more when word gets out that I'm around," says Trapani. "We're expecting a lot of response and a lot of arrests. The floodgates have burst and we're open for business."
Howard County, with 34 registered pharmacies, is a target for organized prescription forging rings that have lucrative markets in the city, Trapani said. Nearby Anne Arundel and Baltimore counties have reported similar problems with forgeries and have started their own prescription drug units within the past two years.
Although the federal Drug Enforcement Administration has broad powers in tracking prescription drug crime, Maryland police departments have just begun to attack the problem.
Trapani says the stepped-up enforcement for prescription crimes must come mainly from the pharmacists, whom he depends on for reporting suspicious incidents. In addition to tips from workers, Trapani expects to visit each pharmacy once or twice a month to look for strange or unusual prescriptions.
"You might have a guy that's visited several pharmacies, or you might find someone that's been taking out 200 Percodan tablets," Trapani said.
"Most of these people just don't do it once. They do it over and over, and they're going to get caught."
In addition to Percocet, the counter drugs typically targeted in the forgeries include Dilaudid, the pain-killers Demerol and Percodan, the stimulant Xanax and the more-potent Tylenol-3 and Tylenol-4 medications, Trapani said.
Single 2-milligram tablets of any of those drugs sell for between $15 and $40 in some parts of the city, where the drugs are viewed as attractive substitutes for heroin, cocaine and speed, Trapani said.
"We're just starting out on this, so we really don't know how big the problem is. But in some city neighborhoods, you can actually watch dealers set up on the street, sort of like a drive-up pharmacy," Trapani said.
Howard County pharmacists say it is difficult to identify prescription forgers, since many have developed a system. And in the cases where the prescription is identified as a forgery, little can be done to prevent the suspect from just running out the door.
The more organized prescription criminals will employ three people for the forgery scheme, say police and pharmacists. A forger needs only to learn a physician's Drug Enforcement Administration registration number and the style of the doctor's handwriting.
After obtaining prescription forms, either through theft or legitimate prescriptions for mild drugs, the forger signs the doctor's name and lists the registration number. A "runner" will then take the form to a pharmacist and try and obtain the drugs.
Typically, the runner will visit the pharmacist on weeknights or on weekends, when the pharmacist would be unable to call the physician's office to verify the prescription. In some cases, a phony phone number is provided on the form and the pharmacist unknowingly calls a drug abuser for the doctor's verification.
"Sometimes they dress up to fool you or get your sympathy," said Julie White, a pharmacist at Feldman's Dorsey Hall Pharmacy in Columbia. "They'll hobble in on crutches and be wearing a phony cast and say they're in a lot of pain."
White's pharmacy opened six months ago and fills approximately 250 prescriptions a week, she said. Forgers, at the pace of about one a week to one a month, regard new pharmacies as targets, she said.
White, who expects to testify in court on an upcoming prescription forgery case, said many pharmacists have dealt with the problem by just denying the forger a prescription. The police aren't typically called, because the penalties involved are light and aren't regarded as worth the time in court, White said.
"A lot of times it gets postponed and delayed. The feeling has been that nobody wants to go to court 10 times for a slap on the wrist," White said.
The charge for passing a forged prescription is a misdemeanor in Maryland. Trapani acknowledges that the maximum penalty -- four years in jail and a $25,000 fine -- is seldom doled out to offenders, a fact that has deterred many pharmacists from calling the police.
In some cases, the forger is charged with possession of a controlled dangerous substance. However, the runner who picks up the drugs is typically not the forger, allowing him the excuse of "Hey, I was just picking this stuff up," said Joe Johnson, a county narcotics detective who has worked on prescription drug cases.
Gail Schindell, a pharmacist at the Long Reach Village Pharmacy who has also testified in prescription forgeries, said it is often difficult to question those who come in the store seeking medication for very serious illnesses, such as cancer.
Schindell says the offenders don't stop at just forging prescriptions.
While working at a Laurel pharmacy several years ago, an armed robber held up the store on four different occasions and took only narcotics, Schindell said.
"It makes you cynical and bitter," she said. "This is expensive, valuable medicine used for people that are suffering. It's awful what some people will do to get it."