On Jan. 31, 2007, Jersey City police officer Victor Vargas filled a prescription for Norditropin, a brand of human growth hormone. He was billed $8, the co-pay set by his government health plan.

Taxpayers picked up the remaining $1,076.

Through August of that year, Vargas, then 30, filled at least five more prescriptions for growth hormone, along with prescriptions for testosterone, an anabolic steroid, and HCG, a drug that boosts production of testosterone in the body, according to legal documents related to an ongoing brutality lawsuit against Vargas and other officers.

In all, the officer paid $96 for the three substances in those eight months. The cost to the public: $7,013.

Vargas’ purchases provide a window into the enormous financial burden borne by taxpayers under a wink-and-nod arrangement between a Jersey City doctor, Joseph Colao, and his loyal patients in law enforcement agencies and fire departments across New Jersey.

A Star-Ledger investigation has found that at least 248 officers and firefighters obtained steroids, growth hormone and other testosterone-boosting drugs from Colao before his death in August 2007. In addition, the newspaper found Colao often falsely diagnosed his patients with hormone deficiencies to justify his prescriptions, a violation of the law and medical ethics.

For the officers and firefighters in the physician’s practice, the drugs came cheap.

Like Vargas, they used their government benefits to pay for the substances in most, if not all, cases. A Star-Ledger analysis suggests the total cost to taxpayers runs into the millions of dollars, driven primarily by Colao's willingness to so widely prescribe human growth hormone, one of the most tightly regulated drugs in the nation.

Strong at Any Cost

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

More coverage:

• N.J. Attorney Gen. Dow forms panel to investigate illegal steroid use by law enforcement officers

• N.J. suspends disability benefits for ex-Harrison firefighter working in N.C. fire department

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

For members of the Jersey City Police Department alone, Colao wrote 235 growth hormone prescriptions in a 13-month period, according to legal filings related to the brutality suit.

The public cost of just those prescriptions, based on an average price of $1,100 per month, runs to nearly $260,000.

Pharmacy records obtained by The Star-Ledger show hundreds of other prescriptions went to law enforcement officers and firefighters from 53 agencies, including the state Department of Corrections, the State Police, the NJ Transit Police Department, county sheriff's offices and municipal departments large and small.

As expansive as Colao’s practice became, the abuse of taxpayer funds for steroids and other hormones didn’t begin or end with one Jersey City doctor.

The Star-Ledger found Colao to be an example of a wider problem, one fueled by a lack of oversight within police and fire agencies, a reluctance by prosecutors to bring criminal charges for insurance fraud and a failure by health plan administrators to flag outlandish claims.

In the years before Colao’s death, for example, New Jersey’s residents were billed $300,000 for steroids and growth hormone a group of Trenton police officers bought over the internet from a Florida dentist, state officials confirmed.

The dentist pleaded guilty to federal drug charges. The officers were investigated but not prosecuted. Three were later promoted.

Since then, insurance companies that administer public health plans have stepped up controls, particularly over growth hormone, but there are signs little else has changed.

The Star-Ledger found hundreds of officers and firefighters, some of them Colao's former patients, continue to receive treatment from doctors who specialize in prescribing testosterone and other hormones.

Several of those doctors said that while they don’t accept insurance for growth hormone because of its strict regulation, they generally do recommend patients use their insurance coverage for testosterone.

Briefed on The Star-Ledger's findings, Attorney General Paula Dow, the state's top law enforcement official, said officers and firefighters who use their government benefits to pay for such drugs when they aren't medically necessary appear to be engaging in fraud.

And at a time when New Jersey faces “crippling” expenses and the lingering effects of the longest recession in decades, Dow said, the state can ill afford to subsidize the recreational use of steroids and other substances among public workers.

“The increased cost of benefits is a major concern for this administration, and if we can show costs are shooting up in the prescription area because of an abuse in the system, that’s just wrong,” Dow said. “It’s borderline illegal, and that alone demands we take a look at this issue.”

A Mounting Tab

Joe Ramundo didn’t think twice about using his government insurance for the trio of drugs Joseph Colao prescribed him early in 2007.

Ramundo, then 42, was a sergeant in the Passaic County Sheriff’s Department. Now retired, he said Colao reviewed his blood tests and told him he needed testosterone, HCG and human growth hormone, all of which were delivered to Ramundo’s Wanaque home from Lowen’s Pharmacy in Bay Ridge, Brooklyn.

“I don’t think he did anything wrong,” Ramundo said. “I felt more alive.”

It is illegal to prescribe growth hormone for all but a handful of conditions in adults. One of them, adult growth hormone deficiency, legitimately affects just one of every 100,000 people annually, according to the American Association of Clinical Endocrinologists.

Told that of that estimate, Ramundo responded, “I know I needed it.”

Apparently, many of Ramundo’s former colleagues feel the same way. He said law enforcement officers from “all over” Passaic County use steroids and growth hormone, mainly obtained from doctors and wellness clinics.

Ramundo said his own regimen lasted about six months, ending with Colao’s death.

During that time, he said, his only bills were $5 co-pays.

Based on the average monthly prices for the drugs Ramundo was taking, the balance likely ran to about $8,000.

“If you need it, you need it,” Ramundo said, questioning why cost was an issue and complaining that insurance companies pocket millions of dollars each year.

“They’re all about the money,” Ramundo said. “They’re full of (expletive).”

But it wasn’t an insurance company that bore the cost of Ramundo’s treatment. Like many counties and municipalities, Passaic County pays medical claims out of a self-insurance fund, meaning tax dollars satisfied the bills.

Ramundo retired from the sheriff’s office in July 2007 with an annual pension of $76,740, records show. In March of this year, he was featured on a reality television show, “The Marriage Ref,” in which his wife told a national audience he spent too much time tanning, grooming and primping.

Ramundo was one of at least 18 Passaic County sheriff's officers or corrections officers in Colao's practice, The Star-Ledger found. Collectively, those officers filled scores of prescriptions for testosterone, growth hormone, HCG and stanozolol, a powerful steroid favored by athletes and bodybuilders, records show.

Other cities and towns that took a financial hit include Newark, Paterson, Union City, Edison and Franklin Township in Somerset County. In each of those communities, at least six officers or firefighters filled prescriptions through Colao. In Bayonne and Hoboken, it was a dozen or more.

Across New Jersey, however, no municipality absorbed a bigger financial blow from Colao’s prescribing habits than his own hometown.

Colao, who was 45 when he died of heart failure, grew up in Jersey City. And when he decided to leave a group practice in Newark, it was to Jersey City he returned, opening an office on John F. Kennedy Boulevard, not far from Lincoln Park.

The struggling pain-management practice took off in 2005 and 2006, former employees said, when Colao recast himself as an anti-aging physician specializing in hormone replacement therapy. By some estimates, he had more than 5,000 patients at the time of his death.

They included at least 40 Jersey City police officers and 27 city firefighters, all of whom received steroids or growth hormone — and in most cases both — through Lowen’s Pharmacy.

Putting a Price on It

To more precisely gauge the cost to the public, the newspaper filed a request under the Open Public Records Act seeking the city’s total payments for growth hormone and anabolic steroids among members of the police and fire departments, or nearly 1,400 people in all. Jersey City’s legal department denied the request.

But a sense of the toll on taxpayers can be found in public documents and in court records filed in connection with a Jersey City resident’s lawsuit against Victor Vargas.

The resident, Mathias Bolton, claims Vargas and another of Colao’s steroid patients, officer Michael Stise, were in the throes of “roid rage” when they mistook him for a burglar and beat him on Aug. 20, 2007. Vargas and Stise are among several officers named in the suit. The officers deny any wrongdoing.

Records subpoenaed by Bolton’s lawyer show Jersey City, which provides medical coverage for its 2,900 employees through a self-insurance fund, spent more than $255,000 on various forms of growth hormone in 2006.

By 2007, when Colao’s practice was at its height, the spending on growth hormone more than doubled, to $677,000.

Seen another way, the city spent more that year to treat growth hormone deficiency, an extremely rare disorder, than on any other medical condition, including high cholesterol, high blood pressure or diabetes, the records show.

Bolton’s steroids expert, Gary Wadler, said in court papers the spending clearly indicates abuse, noting the cost to treat growth hormone deficiency ranked 43rd among other government clients of Express Scripts, the city’s pharmacy benefits manager at the time.

City spending on various anabolic steroids also soared year over year, more than tripling to $160,000 in 2007 from $52,000 the previous year.

Express Scripts apparently rubber-stamped the flood of prescriptions, part of a broader industry failure to monitor the use of medications at the time. In September 2007, a subsidiary of the company, Specialty Distribution Services, paid a $10.5 million fine after federal prosecutors in Boston charged the firm with illegally providing HGH to athletes and entertainers.

Jersey City Mayor Jerramiah Healy declined repeated requests for an interview about the use of steroids by city employees or the costs to the public.

His spokeswoman, Jennifer Morrill, instead released a statement saying Healy would be “troubled” if it was determined any police officer or firefighter was abusing steroids, “much less steroids paid for by the taxpayers.”

“Should the investigations of any law enforcement agencies determine that to be true, the city will demand restitution or civil action to recover those costs,” Morrill said. “However, the mayor cannot presume that the mere existence of a prescription for steroids that was written by a medical doctor and filled by a licensed pharmacy for a city employee is not medically necessary or otherwise a fraud.”

Steroid bills for N.J. law enforcement, firefighters come at taxpayer cost 5 Gallery: Steroid bills for N.J. law enforcement, firefighters come at taxpayer cost

No Charges to Answer

Fred Beaver calls it one of the great frustrations of his career in government service.

On a spring day in 2006, Beaver learned a dozen active and former Trenton police officers had been ordering vast amounts of anabolic steroids and human growth hormone over the internet for two years, beginning in 2002.

And with each purchase, the officers had used their government health benefits. State prosecutors would later peg the cost at $300,000.

As director of the Division of Pensions and Benefits at the time, Beaver oversaw the State Health Benefits Program, a self-insurance fund that covers state workers and employees for more than half of New Jersey’s school districts and municipalities.

Because Trenton participated in the plan, all of the state’s taxpayers were on the hook for the steroid and HGH purchases of a dozen cops.

“I couldn’t believe it,” said Beaver, who retired in April after eight years in the post. “Some of these guys were getting three prescriptions a week for 30-day supplies. It was the most ridiculous arrangement I ever saw.”

Horizon Blue Cross Blue Shield of New Jersey, the insurer that administers the state program, eventually brought the purchases to Beaver’s attention, but he wondered why it had taken the company years to discover them.

“How did they let this go on?” he asked. “Where were the controls?”

The source of the steroids and growth hormone wasn’t even a medical doctor. Jeffrey Weiser, now 50, had been a dentist in Burlington County before giving up his practice and beginning a new life as a personal fitness consultant in Florida.

Part of that business involved peddling steroids and growth hormone for as much as $1,700 a prescription on bodybuilding websites.

Weiser later pleaded guilty to federal charges of unlawfully distributing the substances. In November 2007, he was sentenced to six months’ home confinement and four years’ probation.

Beaver expected the same sort of treatment for the police officers.

“To me, this was a clear-cut case of insurance fraud,” he said.

Beaver said Horizon forwarded the allegations to the Mercer County Prosecutor’s Office, which spent months on the case but ultimately declined to bring charges. Incensed, the former pensions director wrote a letter to the state Attorney General’s Office requesting another probe.

That investigation lasted more than a year, ending quietly in late 2008 without an indictment.

“That points to the problem in this state,” said Beaver, who now works in the private sector. “This is taxpayer money. If you’re not willing to take this on, if you’re willing to absorb hundreds of thousands of dollars in costs, I think it’s ludicrous.”

The case was equally frustrating to Joseph Santiago, then Trenton police director.

Santiago, who now serves as police director in Irvington, cast the issue in moral terms, saying officers charged with upholding the law, and who sometimes testify under oath in narcotics cases, appeared to be buying drugs illegally.

At the same time, he said, he worried officers on steroids could be susceptible to episodes of increased aggression. Santiago said he reviewed the officers’ records, finding a “significant amount” of excessive force complaints.

“When you looked at these records, you start to see where there might be a correlation,” he said. “Is it absolutely clear? No. Would a complaint have been there regardless of steroids? Those are issues that need to be addressed.”

One of the officers, Jason Woodhead, was named in a civil suit alleging he and another officer severely beat a 53-year-old man in 2004 for disobeying an order to remain in his home while the pair conducted an investigation outside.

The resident, Charles Hendrix, suffered a broken nose, broken ribs, a broken hand and spinal injuries, according to the suit. In April of this year, the city settled with Hendrix for $500,000, court records show. Taxpayers picked up that tab, too.

Woodhead, now 32, was one of six officers implicated in the internet purchases to remain on the Trenton force through the state and county investigations.

The others are Sgt. John Zappley, 43; officer Matthew Przemieniecki, 32; Detective Randall Hanson, 41; Detective Anthony Manzo, 50; and Lt. Joseph Valdora, 50, the president of the department’s Superior Officers Association.

In September 2008, as the investigation dragged on, Santiago stripped the officers of their weapons and put them on desk duty. Within a week, all but Hanson were in a Trenton courtroom, asking a Superior Court judge to compel Santiago to return their weapons, according to a published account. The judge declined.

It turned out to be moot.

Santiago left the department later that month, forced out because he did not comply with the city’s residency requirement. The officers were soon reinstated.

Woodhead and Manzo are now sergeants in Trenton. Valdora, promoted to captain in April 2009, retired in October. None of the officers responded to requests for comment.

A seventh officer, Detective Robert Smith Jr., took a job with the Mercer County Sheriff’s Office. Today, he is chief instructor at the county police academy. Smith did not respond to requests for comment.

The other five officers retired either before or directly after the internet purchases were discovered. Four of them could not be identified. The remaining retiree, Sgt. Richard Merlino, left the department in December 2004 at age 41.

Merlino, who now lives in South Carolina, called the allegations “90 percent baseless.”

“There’s a lot of untruths to the story,” he said.

In response to the complaints by Beaver and Santiago, a spokesman for the Attorney General’s Office said prosecutors, after a careful analysis, determined they couldn’t prove the officers intended to break the law.

Several factors played a role in the decision, said the spokesman, Peter Aseltine, noting that Horizon signed off on the officers’ reimbursements and that a pharmacy filled the prescriptions.

In addition, Aseltine said, the dentist misled his customers by identifying himself as a medical doctor, a fact cited by the officers in claiming they didn’t realize they were engaging in wrongdoing.

“I’m not commenting on the validity of the officers’ claims, but I am commenting on the difficulty we would have had in proving the requisite mental state,” Aseltine said. “The mental element can be the hardest part of a case to prove.”

Casey DeBlasio, a spokeswoman for the Mercer County Prosecutor’s Office, declined to comment.

Tightening the Reins

If one positive development has emerged from the misuse of taxpayer funds for muscle-building drugs, it’s that the insurance industry is paying better attention.

Prescriptions and reimbursement claims for human growth hormone are no longer routinely waved through without a second look, industry officials say, and doctors who prescribe large amounts of steroids are more likely to face inquiries from investigators.

“We’ve got some good controls in place across many of our products now,” said Thomas Rubino, a spokesman for Horizon, the state’s largest insurer. “We challenge and seek additional information from the provider making a request for the prescription of a human growth hormone or a steroid. Awhile ago, that would have just gone through the system.”

The changes grew out of hard lessons.

Beyond the Trenton case, Rubino said, the company took note of spikes in steroid and HGH prescriptions in 2006 and 2007. By looking deeper, investigators found millions of dollars had been lost to fraud.

"The cases we investigated have been significant-dollar cases," Rubino said.

Other industry officials say investigators are now better trained to look for patterns that could indicate fraud.

A patient taking an anabolic steroid in conjunction with an estrogen-blocker, for example, might signal an effort to avoid the development of excess breast tissue, a side effect of steroid abuse. A large number of young men receiving testosterone from a single doctor also would raise a red flag.

“All these drugs have legitimate and important medical uses, but you have to look at the context of how they’re being prescribed,” said Steve Russek, chief clinical officer of Accredo Specialty Pharmacy, a division of Medco Health Solutions.

Medco administers prescription benefits for some 65 million people across the country. When former Passaic County sheriff’s officer Joe Ramundo put through his claims for growth hormone and testosterone, it was Medco that signed off on them.

The increased scrutiny may have cut the costs to taxpayers, but it hasn’t entirely eliminated them.

Testosterone — which can run up to $300 per month, depending on the dose and the form in which it’s delivered — is a staple drug of the growing anti-aging industry. And in doctors’ offices and clinics where anti-aging medicine is practiced, law enforcement officers and firefighters can often be found.

Santiago, the former Trenton police director, contends the use of steroids in the ranks — and the related burden on taxpayers — will remain a problem unless departments and prosecutors get tougher on the issue.

“You need to signal to everybody that it’s not okay to do this,” he said. “Cops are like everyone else. They pay attention.”