It starts the way many robbery stories start.

A guy in dark clothes walks in with a gun and orders someone behind the counter to open a safe.

But unlike other holdups, this robber isn’t after cash. He wants painkillers, primarily oxycodone, and the pharmacist is the only one who can access it.

Unprepared for such a threatening scenario, the pharmacist complies, and the robber flees with hundreds, if not thousands, of pills.

This scenario happened at least 13 times at Lowcountry pharmacies in 2012, up from about four in 2011. It’s a trend that’s been spreading across the country over the past few years, and it’s indicative of just how addictive these drugs can be and the profits thieves stand to make by stealing them.

Average people are risking everything for a bag of pills, and holdups aren’t the only methods they’ll use.

In January, thieves burglarized three area pharmacies — one in Mount Pleasant, one in West Ashley and another in Moncks Corner. The Moncks Corner store was hit twice in the same night, allegedly by the same people, who later wrecked their car. Police said they found some 10,000 pills worth $40,000 in the home of one suspect.

The pill theft trend is like a tree with deep roots and many branches, and as it grows, so do the number of dangerous drugs that fall into the wrong hands.

South Carolina is hardly alone in this problem. Police in Augusta, Maine, recently joined forces with federal investigators to combat pharmacy robberies after the city recorded nine such holdups in 2012. And just last month, robbers hit two pharmacies in a single day in San Francisco on the hunt for pills.

In December, a former South Carolina sheriff’s lieutenant from Georgetown was arrested in Santa Fe, N.M., and accused of robbing one pharmacy of oxycodone and attempting to hold up another. Police said his wife, a Santa Fe prosecutor, recognized him on a surveillance video and called authorities.

Addiction or profit?

When pills were stolen from local pharmacies in the past year, no one tried to steal cash. The thieves have been after pills and only pills — a trend that has left local law enforcement officials scratching their heads.

“Who knows who these suspects are?” said Thomas Nuse, assistant special agent in charge of operations with the U.S. Drug Enforcement Administration in South Carolina. “Are they users or are they dealers who can steal the pills and make a decent profit off of them?”

Most robbers have been after oxycodone, one of the most powerful and addictive pain medications on the market. It’s called an opioid because it’s basically a synthetic version of opium, according to the U.S. Food and Drug Administration.

Like opium and heroin, opioids are derived from the poppy plant, which is why they create intense sensations of euphoria when taken in high dosages. Their origin also explains why opioids are so addictive.

Jonas Coatsworth has treated hundreds of opiate-addicted patients as the program administrator for the Opioid Treatment Program at Charleston Center. He said opioid-dependent people will do whatever it takes to feed their addictions.

“The majority of people who are opioid-dependent have criminal histories,” Coatsworth said. “Getting the drug ‘off the street’ includes illegal things, i.e. robbing pharmacies, to obtain it.”

Addiction may be enough to drive people to hold up pharmacists, but since pills are being stolen by the thousands, and considering how valuable they are to addicts, there could be another motive at play: money.

“If this stuff is selling for $1 per milligram on the streets, well then that’s a pretty lucrative business,” Coatsworth said.

A single oxycodone pill could sell for up to $80 on the street, Nuse said. But with a prescription, a low-dose generic pill could cost as little as 50 cents apiece at the pharmacy.

When a Summerville CVS was robbed of nearly 3,000 oxycodone pills (generic and brand name in different doses) on Aug. 23, the pharmacy lost about $18,000 in inventory. If the robber were to sell that pill collection on the street, he could make up to $95,000.

It essentially comes down to economics. When oxycodone can’t be found on the streets, the demand for it increases. And this isn’t just any demand — it’s an addict’s demand, which means dealers can charge whatever they want for the pills on the street.

This isn’t a novel trend. In 2006, an increased demand for oxycodone spawned an increase in pharmacy robberies around the state, Nuse said.

Not there to hurt

Deb DaPore is a local pharmacist and owner of Plantation Pharmacy. In February 2011, her pharmacies on James Island and West Ashley were robbed at gunpoint exactly two weeks apart by the same man.

Like many robbers, he was after oxycodone.

DaPore wasn’t present at either of the robberies, but she said her employees were able to handle the situation calmly.

“If you just give them what they want, you know there won’t be any harm done,” she said. “It’s not any less scary, but you understand that he’s only there for one purpose.”

During one of the hold-ups, the man even told the pharmacists that he wasn’t there to hurt them, and that he only needed his medication, DaPore said.

“I think you have to be in this business to really understand the desperation that these people feel,” she said. “They’re hooked on a drug that they can’t get, and they just don’t want to hurt anymore.”

Not just killing pain

The cycle of opioid abuse begins in various ways. Nuse said young people get it from friends or take it from their parents’ medicine cabinets. DaPore thinks it most often stems from honest medical treatment.

“I think a lot of it is patients who had legitimate reasons for using the drug for injuries,” she said. “It’s unfortunate that when somebody’s in pain, doctors will just keep increasing the dosages instead of switching them to another drug.”

Once people make a habit of taking high-dosage opioids, they’re much more at risk for addiction, abuse and even overdose, according to the Centers for Disease Control and Prevention.

“The dangers of medications are sometimes overlooked,” Nuse said. “It’s almost accepted, like, ‘Oh, it’s just a pill, it can’t hurt me.’ ”

But opioid medications are far from harmless. Prescription drug overdoses caused 225 deaths in South Carolina in 2011, and more than half of those deaths (121) were caused by opioids, according to DHEC.

In 2008, opioids caused 28,000 of the 36,450 prescription drug-overdose deaths in the United States. Prescription drugs were almost as deadly as automobile crashes, which killed about 39,900 people, the CDC reported.

A tragic death

Those aren’t just numbers for Charleston School of Law student Lauren Byrns. In February 2012, oxycodone killed her brother, Ben Byrns, in his sleep. He was a 20-year-old student at Florida State College in Jacksonville, Fla.

“I don’t think he was a user,” she said. “The toxicology report came back a few months later, and it was the slightest bit of oxycodone in his system. There was nothing else there — no other drug.”

Byrns said she thinks someone gave Ben a pill to help him sleep that night.

Since then, Byrns has signed a petition to ban the drug OxyContin, a brand name with a potent time-release oxycodone formula. The petition, found at, has about 13,000 signatures.

Once she earns her law degree, Byrns said she wants to be a lobbyist and push for more regulations of drugs such as oxycodone.

“I don’t think (opioids) should even be on the market,” she said. “There has to be another alternative that doctors can prescribe.”

Byrns’ boyfriend, Gantt Williams, agreed. In the past few years, he’s had several friends die from heroin overdoses — a drug habit that he said was triggered by oxycodone abuse.

“All OC is in my terms is a gateway drug,” he said. “It’s just so strong, and it’s hard for young people to overcome. And if they can’t find it anymore, then they’ll switch to heroin. That’s why it’s so dangerous.”

Holes in the safety net

It’s still unclear how many pills were stolen in South Carolina last year. State records on the subject appear to be incomplete.

The federal Controlled Substances Act classifies opioids as a Schedule II substance, which means it has a high potential for abuse. The law requires the DEA to closely record any diversions of schedule II drugs, to make sure the drugs aren’t falling into the wrong hands.

The DEA website says it collects data from Forms 106, documents that pill providers are required to fill out and send to the DEA any time controlled substances are stolen or lost.

The Post and Courier requested that data from the state Department of Health and Environmental Control and the DEA, to get an idea of just how many pills were stolen or lost in the area last year.

Nuse said an intelligence department would have to analyze each form to come up with that data, and he said the agency was unable to do that.

A representative with DHEC then sent an email to the newspaper containing incorrect information.

“We have completed our review of DEA 106 forms received in our office for 2012 for the counties of Charleston, Dorchester and Berkeley,” the email said. “We had two armed robberies both in Summerville … total doses stolen are 1171 of oxycodone ER (generic OxyContin) in various strengths.”

After analyzing individual police reports, The Post and Courier discovered there were at least three robberies in Charleston, four in Summerville, five in North Charleston and one in Walterboro.

The total haul remains hazy because some police reports left out the types of pills stolen and others only provided how much the stolen pills were worth.

Mixed bag of solutions

Right now, local law enforcement handles the pharmacy robberies on a case-by-case basis. Most of the robbers have been caught and sentenced to jail time, and employees of the robbed pharmacies are educated on how to protect themselves, according to North Charleston Deputy Chief Scott Deckard.

“I told (the pharmacy employees), ‘If you see somebody acting suspiciously, don’t hesitate to call us,’ ” he said.

At the state level, Nuse said the DEA hosts drug buy-backs, which allow people to dispose of unused medications. The agency is also conducting ongoing investigations of drug dealers who sell prescription medications on the street.

Coatsworth said he doesn’t think that’s enough to combat the problem.

“You can lock people up, but that’s not going to stop them from doing these kinds of things,” Coatsworth said. “The one way to address this problem is to get out more information about what treatment is available.”

The Opioid Treatment Program Coatsworth directs has two components: mandated counseling sessions and methadone treatments to help people wean themselves from opioids.

“When it comes to opioid dependence, medication-assisted treatment is the way to go,” he said. “This is what the empirical evidence and research say works.”

DaPore, the pharmacist, said she thinks high-dosage oxycodone should be taken off the market altogether.

“That would get rid of a lot of the potential for abuse,” she said.

Williams, who works at the Bank of South Carolina in West Ashley, said he thinks pharmacies should deal with the threat of robberies the same way banks do: reduce the inventory.

“We can only have a small amount of cash in the vaults, so if somebody does come to rob us then they’re not going to get much cash and they’re going to get caught and face a lot of time,” he said. “If you can’t access all the pills you wanted then you wouldn’t risk going to jail. But if they can steal hundreds of thousands of dollars’ worth of pills, well then, that’s their motivation.”

Reach Abigail Darlington at 937-5581.