They sit in the library or at a computer, studying for hours, they make an appointment and then put on an elaborate show for a doctor with the hopes of a big payoff.
Drug shoppers or scammers are hitting up local doctors and trying to score prescription drugs, then sell them on the streets or feed an addiction. In our four part series this week, we've learned it's a real problem here in Moose Jaw. Local police are leading the way with new techniques in fighting the prescription drug trade and doctors are helping in the battle.
There was a time when Moose Jaw was a drug traffickers tourist destination. Corporal Taylor Mickleborough has told us that users and dealers would come to our city just so they could scam doctors because our clinics were seen as easy pickings. Something had to be done and he set to work tracing the pills from the street, back to the clinics where they were being prescribed.
Along the way Mickleborough found lives, families and careers that were destroyed by the drug trade. Normal every day people who had fallen into a pit of drug abuse that had taken everything from them. He also found dealers who cared more about the money they were getting for selling narcotics than the lives they were ruining. Then there were the doctors who were caught between a rock and a hard place. Doctors who had took an oath to care for their patients but were getting tricked into writing prescriptions for fake problems.
It led to a realization that current techniques for dealing with drug abuse were not working and a multi-level approach was needed to try and stop the flow of drugs from clinics to the streets. Mickleborough started working with the College of Physicians to see what could be done to educate doctors about what was really happening. While no one is pointing a finger at the doctors and saying it's all their fault, the College soon realized there were changes that could be made that could improve the situation.
Doug Spitzig is the Pharmacist Manager of the Prescription Review Program and says one of their recommendations will be for more training in the area of chronic pain. "Physicians receive five to seven hours of training in chronic pain in medical school while veterinarians receive about 70 hours of training. Adequate training for the general practitioners and establishment of more chronic pain specialists and clinics."
While recommendations can lead to change, something needed to be done in the immediate future. Mickleborough and Spitzig started a quest to tell doctors about the problem, let them know about some of the common scams being used to get prescriptions and who some of the problem users and dealers were around the area.
Over the last six to nine months, things have improved in Moose Jaw and local doctors are taking a different approach to prescribing narcotics. But there have been some side affects. Morphine, oxy and ritalin are just a few of the drugs being abused but they are also prescribed on a daily basis. With the shortage of doctors and a waiting room full of patients, it can be difficult to sort through potential scammers.
"There are times when you know that the patient has a legit problem and you know you want to prescribe a narcotic for example, but you're almost scared to prescribe that narcotic." confessed Dr. Brad Thorpe, Chief of the Medical Staff in Moose Jaw. "You're concerned that patient may not use that drug appropriately or sell it. Ultimately, we have to use our best judgement which sometimes is difficult and a lot of times it can be very uncomfortable."
When he was first approached by police and told about the problem in Moose Jaw, Dr. Thorpe says he was amazed at some of the people accused of abusing or selling drugs. Some of his own patients who had been coming into his office for months. He quickly jumped on board and organized a special presentation for the medical community on the problems that had been identified by Mickleborough and the College of Physicians.
"I don't think we were aware that this sort of thing does happen." said Thorpe. "I think in the back of our minds we all realize there are people who do that but I don't think we realized the extent to which this has been occurring in our own city."
Recognizing there is a problem is half the battle and doctors started watching for the warning signs but in the end they still had to treat the patient, so the College worked with the doctors to develop new programs to follow up with the patients to make sure they were not running to the pharmacy and then selling their prescriptions on the street.
Dr. Thorpe says they can do random urine tests to determine if their patient is actually taking the medication that has been prescribed. "If a patient is supposed to be on a medication, we can check to see if that medication is in their urine. We can also check to see if another medication is in their urine."
"An example would be a somebody who might have Attention Deficit Disorder and may have been prescribed ritalin. He then goes and sells his ritalin to buy his morphine." Thorpe says the urine tests have proved to be a valuable tool and they have spotted a few dishonest patients since implementing the new procedure.
Another tool that he started to use in his own office is a contract with the patient. He explains that the contract lays out the expectations of the patient when being prescribe a narcotic like morphine. It says the patient will only receive their prescription from Dr. Thorpe, they will only get it filled at one pharmacy, they may not get an early refill and are expected to guard their prescription.
Of course, there are special circumstances but Thorpe is taking the contracts with his patients very seriously. Even if the patient claims their pills were stolen, he wants to see a police report proving there was a theft before he will issue a few more pills to get the patient through to their next refill.
Thorpe told the story of how one patient came in and explained that his prescription had been lost while out on a canoe trip. The boat capsized and the patient's pills sank to the bottom of the lake. So, Dr. Thorpe refilled the prescription but when he heard the exact same story a few more times later in the day from other patients, he realized he had been scammed and the first patient was telling his friends how he got extra drugs.
While Thorpe agrees there is still more work to be done in the battle against prescription drug abuse, he's pleased with how far they've come in a short amount of time. The next step is preventing people from getting addicted in the first place and that can come from better treatment of chronic pain.
In Part Four of our series Friday afternoon, we'll explore the options for treating addicts once they've had enough of the life of drug abuse.http://www.discovermoosejaw.com/index.p ... Itemid=681