The multifaceted strategy is likely to include more aggressive investigations, increased steroid testing of officers and tougher oversight of doctors, the attorney general said
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TRENTON — The state has taken its first concrete step to combat steroid abuse among law enforcement officers and firefighters, enacting new safeguards in the prescription benefits plan used by hundreds of thousands of New Jerseyans.
Attorney General Paula Dow called the changes part of a multifaceted strategy that, when fully implemented, is likely to include more aggressive investigations, increased steroid testing of officers and tougher oversight of doctors.
Dow has marshaled top officials from across the state to address steroid use in the ranks, an issue brought to light in a series of Star-Ledger reports in December.
The newspaper found that hundreds of officers and firefighters had filled prescriptions for anabolic steroids and human growth hormone from an unscrupulous Jersey City doctor, Joseph Colao.
Colao, who has since died, often faked diagnoses to justify the prescriptions, which were paid for in most cases by government-sponsored health plans. The cost to taxpayers ran to millions of dollars.
Within days of the reports, Dow assembled a study panel that includes prosecutors, deputy attorneys general and the heads of three state divisions. The eight-member committee has since heard from a variety of experts and examined potential solutions that cut across multiple layers of government.
"It’s interesting how many branches of government touch on this," Dow said. "One huge step forward is that we’re getting all these various entities to talk to one another."
The panel is expected to issue its recommendations to Dow by next month. Last week, the attorney general briefed The Star-Ledger on the group’s progress and laid out the prescription drug changes, which took effect March 1.
"This is not going to be the last word," Dow said. "This is a major beginning."
A three-part Star-Ledger series on the secret world of steroid use by law enforcement officers and firefighters.
• About this series
• List of law enforcement agencies, fire departments
• Glossary of terms
Part 1: Sunday
• N.J. doctor supplied steroids to hundreds of law enforcement officers, firefighters
• Five deaths in 19 months linked to steroids, Lowen's pharmacy
• Legal cases linked to N.J. police who received steroids through Dr. Colao
• Ex-Jets quarterback Ray Lucas was prescribed steroids, HGH by Dr. Colao
Part 2: Monday
• N.J. taxpayers get bill for millions in steroid, growth hormone prescriptions for cops, firefighters
• Ex-Harrison firefighter on disability works full-time for N.C. fire department
• N.J. lawmaker calls on attorney general to investigate steroids, HGH use among law enforcement
Part 3: Tuesday
• Booming anti-aging business relies on risky mix of steroids, growth hormone
Additional coverage:
• N.J. to investigate illegal steroid use by law enforcement officers
• N.J. suspends disability benefits for ex-Harrison firefighter working in N.C. fire department
• Heads of largest N.J. police unions support random steroids testing for officers
• Magazine for N.J. law enforcement contains ads for anabolic steroid providers
• Two bills to address steroid use among N.J. law enforcement officers, firefighters
• N.J. pension board members denounce former Harrison firefighter as a cheat, fraud
• N.J. Assembly panel approves stricter rules on growth hormone use
The measures are the result of collaboration between Dow’s committee and Medco, which administers prescription benefits for some 700,000 people, including dependents, enrolled in the State Health Benefits Program.
The taxpayer-funded program, essentially an enormous self-insurance fund, covers state workers and employees of more than half of New Jersey’s school districts and municipalities.
In broad terms, the new rules more tightly restrict insurance payments for anabolic steroids and human growth hormone.
Before a prescription for any anabolic steroid is filled, a doctor or pharmacist must attest in writing or over the phone that the drugs are for a medically accepted diagnosis. An identical requirement for growth hormone has been in place since last year.
The measures are most stringent for certain powerful steroids that have a history of abuse. For instance, Anavar, a drug popular among bodybuilders, may be prescribed for only a small number of medical conditions, such as anemia and "wasting syndrome," a side effect of AIDS and other debilitating diseases.
Safeguards also have been put in place for testosterone, the most commonly prescribed anabolic steroid and a staple drug of the booming anti-aging community, which touts its benefits as a muscle-builder that boosts energy levels and sex drive.
Under the new policy, prescriptions for testosterone may be filled only if a patient has a testosterone level below a medically accepted standard. The change is meant to weed out bogus claims of testosterone deficiency, a diagnosis Colao used for nearly all of the officers and firefighters in his practice.
Steroid and growth hormone prescriptions for what Medco describes as "anti-aging purposes" — in essence cosmetic reasons — are now rejected outright.
STRIKING A BALANCE
Dow called the issue a challenging one, saying that because steroids and growth hormone are appropriate for some medical conditions and legal with a valid prescription, the state’s response must strike a balance.
"Our objective is not to make it harder for people who have a legitimate need for steroids or growth hormone to receive those medications, but rather to make it far more difficult both for patients without a medical necessity to receive these drugs and for doctors to improperly prescribe them," she said.
Anabolic steroids carry potentially serious side effects that include prostate enlargement, sleep apnea and an increased risk of heart attack and stroke. In addition, they’ve been linked in some cases to increased aggression and recklessness.
Once the committee turns over its full list of recommendations, Dow said, she expects other initiatives to be rolled out over time.
Over the past three months, the group has heard from endocrinologists and attended multiple meetings with representatives of Medco and the Division of Pensions and Benefits, along with personnel from the Division of Consumer Affairs.
Consumer Affairs oversees the State Board of Medical Examiners, which regulates New Jersey’s 33,000 doctors. At issue is whether the state needs to adopt new regulations to increase oversight of physicians, Dow said.
The committee also has had discussions with county prosecutors, the Division of Criminal Justice and the Office of the Insurance Fraud Prosecutor. Those talks have had two aims: examining past steroid investigations of law enforcement officers and sending the message that future prosecutions need to be more aggressive, Dow said.
The attorney general said it is too soon to say if the committee will recommend adding steroids to the list of drugs for which police officers are randomly tested, a move the heads of New Jersey’s two largest police unions said they would support if they have a hand in shaping the policy.
MORE TESTING LIKELY
At the least, Dow said, testing of law enforcement officers is likely to increase under the state’s existing "probable cause" guidelines, which allow police chiefs or prosecutors to order tests if they have reason to suspect illicit drug use.
As they now stand, the guidelines make no reference to steroids, and chiefs have interpreted them differently over the years. Moreover, officers ordered to undergo testing have occasionally filed suit against their own departments, claiming a violation of constitutional rights. The result has been very little testing.
First Assistant Attorney General Phil Kwon, the committee’s coordinator, said he believes a combination of initiatives — along with continued communication among agencies — will help identify steroid users and prevent others from experimenting with the drugs.
"We can’t do one thing to stop all of it, but we can set up choke points along the way," he said.
Kwon also said he expects individual police departments will pay close attention when his panel’s full report is made public.
"I think it will make explicit to police departments that this is a real problem," he said. "Sometimes being on notice goes a long way."