Pharmacist Chuck Gass has no way of knowing if a customer legitimately needs prescription painkillers or is shopping around North Georgia drug stores in search of an illegal high.
He can better detect the intentions of Tennessee customers who come to his Ringgold, Ga., pharmacy.
Tennessee has a monitoring program that tracks the amount and type of narcotics prescribed to patients, but Georgia does not.
“It’s amazing how many people go to different doctors and different pharmacies and get the same thing every day of the week,” said Mr. Gass, owner of Ringgold Pharmacy Shop.
It’s called doctor shopping when patients visit several medical providers to collect prescriptions that they may use or sell.
Abuse of pain medicine like oxycodone ranks as the nation’s second-most prevalent drug problem — behind only marijuana use — according to the White House Office of National Drug Control Policy.
About 6.4 million Americans report nonmedical use of prescription drugs, according to the agency.
Timothy Smith, a 16-year-old Ringgold High School student, died March 1 from a prescription drug overdose. A 15-year-old faces involuntary manslaughter and other charges after police said he stole oxycodone pills from his cancer-patient grandfather and gave them to Mr. Smith and two other teens.
DOCTOR TO INVESTIGATOR
The alarming growth in prescription misuse has forced doctors to adopt investigative skills.
Dr. Frances Barnett, chief of staff at Grandview Medical Center in Jasper, Tenn., implemented a monthly drug screening policy for her patients about a year ago.
“Let’s say I’ve written you a prescription for OxyContin, and you come back for your drug test, and it’s not there,” Dr. Barnett said. “Well, where is it? If you are not taking it, you may be selling it, and that will get you out of my practice.”
Dr. William Hays, of Cleveland, Tenn., said he watches for telltale signs of doctor shopping, such as new patients traveling long distances to his office, or patients who talk about dissatisfaction with a previous provider.
“If they come in and they have a broken foot, that’s one thing. But if they come in and say they just need to get their Lortab refilled, they are probably going to leave my office not very happy,” Dr. Hays said.
Even police are wary of drug abusers who falsely report their medicine stolen to give doctors proof they need more pills.
“A lot of times, police are saying we won’t file that report,” said Larry Black, commander of the Lookout Mountain Judicial Circuit Drug Task Force in Northwest Georgia.
A Tennessee law passed last year makes doctor shopping by people on TennCare a felony punishable by two years in prison.
A broader statute aimed at abuse of private insurance plans is being considered this year.
Since the law passed in July, 809 doctor-shopping investigations launched, said Tennessee Inspector General Deborah Faulkner. An investigation this month led to the arrest of six people in McMinn County, Tenn.
Ms. Faulkner said the law’s success has been fueled by doctors providing information on potential prescription abuse and by confidential tips prompted by cash rewards.
“It’s clearly an indication that the medical providers in Tennessee are fed up with recipients that are wasting their time and talents,” Ms. Faulkner said.
Georgia has a doctor-shopping law, but is focusing on a prescription-monitoring program.
Twenty states had a monitoring system and two dozen more were implementing a program in 2006 when public policy consultants Simeone Associates prepared a report for the U.S. Department of Justice.
The report states that the rate of painkiller abuse would have been 10.1 percent higher and stimulant abuse would have been 4.1 percent higher in the absence of regulatory control.
Bill Atkins, director of the Georgia Drugs and Narcotics Agency, said his office investigates about 10 doctor shopping cases a week. It’s most prevalent, he said, in towns that border Alabama and Tennessee where prescription-monitoring programs already exist.
“The dopers in Alabama know they will be caught there, and they know we don’t have that capability in Georgia yet,” Mr. Atkins said.
The state is applying for a federal justice grant to pay for the monitoring program. Tennessee has been awarded similar grants.
The Georgia House of Representatives approved the monitoring program 149-8, and it awaits review in the Senate. Rep. Martin Scott, R-Rossville, voted against it.
“The bill constituted an unnecessary invasion of privacy of innocent citizens,” he said.
Mr. Atkins said the state also had to alleviate pharmacists’ concerns that a monitoring system would make their job more cumbersome and costly.
Mr. Gass said he welcomes the extra work at Ringgold Pharmacy Shop. “It wouldn’t be a hassle. It would be a relief,” he said.