Moose Jaw Forum

It started with a realization. Moose Jaw has a drug problem. Prescription narcotics being abused and sold for a profit. Local police accepted the problem and said something had to be done.

Canada is said to be the second largest user of prescription narcotics in the world according to a new report. A statistic that didn't surprise Moose Jaw Corporal Taylor Mickleborough. He's seen the abuse first hand and has helped in the fight against it.

Through their normal day to day dealings with drugs in the City of Moose Jaw, officers noticed more and more users of prescription drugs. As they dove deeper and learned more about the situation in our city, they saw a need to not only stop the flow of drugs but to help the people who were addicted.

"Most of the drugs were coming from Moose Jaw itself. They were coming from prescriptions that were obtained locally." explained Mickleborough. "The most commonly abused prescriptions are morphine and oxy and in fact, Moose Jaw was known as a hot spot where people were able to readily access prescription drugs and we were experiencing people coming from out of town and getting their prescriptions here."

Realizing something had to change and that normal police tactics were not working, Mickleborough and his partners at the Moose Jaw Police Service focused on cutting off the flow of drugs. That meant finding out how addicts were scamming doctors into filling out prescriptions.

Through the help of addicts themselves who were looking for a better life and to prevent others from falling into the pit of drug abuse, police started tracing the drugs from the street level, to the pharmacy and then back to the doctors.

"When we did start to get the information from them (addicts), we learned who the problem users were in town and we also learned who the problem dealers were in town and by communicating that information to the College of Physicians and Surgeons, who then relayed that back to the doctors, we were able to educate the doctors on what was really happening on the streets in Moose Jaw."

Through the process, Mickleborough came to realize that not all of the abusers were bad people. He came across tragic stories of people who had healthy lives before becoming addicted for one reason or another. Maybe from recreational use that turned into addiction or the back surgery patient that got hooked during treatment. The addiction slowly took away everything that was important to them until all that was left was the craving for their next fix, leading to criminal activity so they can afford the drugs.

The doctors have really accepted the new approach according to Mickleborough who said some were really surprised to learn the extent some patients would go to just to get their prescriptions. Some would spend hours online researching diseases and ailments, the symptoms and how to fake them. They would then go to a clinic and convince a doctor to write a prescription.

Just knowing what was happening has helped doctors look at things a little differently according to Mickleborough. "After that, we've seen a lot of prescriptions tightened up and it's a lot harder to get faulty prescriptions in town."

Mickleborough worked with the College of Physicians to develop a program to help doctors look for warning signs that someone might be trying to scam pills. New procedures have been introduced to follow up with patients to make sure they're not selling them and the program has been applauded at the international level for being innovative.

As we continue our four part series on the abuse of prescription narcotics, we'll take a look at those new procedures that doctors are learning about, we'll talk to a local doctor about his experiences with users and how he tries to deal with the fine line of treating a patient and worrying about being scammed.

We'll also look at treatment options that are available to people who have had enough of a life under the influence of prescription drugs.

It came as a surprise to some Thursday morning as they learned that Moose Jaw was considered easy pickings when it came to scamming doctors for prescription drugs. There was a time when users, abusers and dealers would make trips to our city, specifically to obtain faulty prescriptions. The drugs then made their way onto their streets or into the veins of addicts.

Local drug investigators wanted to change that and have been working with the doctors to prevent faulty prescriptions. Over the last couple years, officers have teamed up with the Saskatchewan College of Physicians to educate doctors and develop programs to make sure patients are not taking advantage of the helpful and trusting nature of doctors.

In Part 1 of our four part feature on drug abuse in Moose Jaw, Corporal Taylor Mickleborough explained how they set out to tackle the problem from another angle. Instead of focusing on putting people behind bars, they took a humanistic approach and offered to help addicts who wanted to climb out of the life of drugs.

As they developed relationships, trust and even friendships with local residents, those addicts began helping police trace the drugs from the street level and back to medical clinics. Wanting to prevent others from a life of hardship, the addicts explained how they would scam doctors out of drugs, where they could get information about faking an illness or injury or who was doing it and then selling the drugs on the street.

Mickleborough soon realized this was more than just a Moose Jaw problem and more than police could deal with on their own. He soon crossed paths with Doug Spitzig at the Saskatchewan College of Physicians and Surgeons. He's the Pharmacist Manager of the Prescription Review Program and took a keen interest in what Moose Jaw Police were doing.

"Rather than going through the judicial stream, we'd take a look at going through the medical stream." explained Spitzig from his office. Just like Mickleborough, he realized that normal drug intervention programs were not doing enough and they needed to find a way to get doctors involved without making them feel like part of the problem.

"They (doctors) want what's best for their patient and they have take the patients word for what the ailments are." said Spitzig when asked what one of the biggest difficulties for doctors is. "When people come and they try to deceive the physicians, they really don't have a lot of training in that and that's where we come in and try to help the physicians."

That's why new programs are being developed, such as the urine screening tests that will tell the doctor if their patient is actually taking the drugs being prescribed or is potentially selling them. Spot pill counts are also being used by doctors and so are contracts where the doctor sets out rules for refills and what happens in the case of lost or stolen medication.

As Canadians become more and more dependant on popping a pill to deal with pain, Spitzig says doctors will need more training. "Physicians receive five to seven hours of training in chronic pain in medical school while veterinarians receive about 70 hours of training."

"That will probably be one of the recommendations, adequate training for the general practitioners and establishment of more chronic pain specialists and clinics."

With new procedures, tools and information at their disposal, doctors are starting to make a difference in cutting off the flow of drugs from their offices and into the streets. But now there is a new concern in the medical community. A growing mistrust of patients. Doctors wondering if the patient sitting in their examination room is truly in extreme pain or just trying to scam drugs.

Friday morning, we'll take a look at the drug trade from the doctors point of view and the awkward moment they lose trust in a patient.

http://www.discovermoosejaw.com/index.p ... Itemid=681

Ritalin is the drug of choice..and doctor's prescribe this too often when the child does not have ADHD..and this is always on the recommendation of the teachers.
This news item does not surprise me in the least..prescription drugs have always been a problem in our city.

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

I dunno, I just don't know. The idea of local cops strongarming doctors into not prescribing necessary medications is very, very worrisome to me. Yeah, there are always jackasses abusing stuff, Darwin generally takes care of them. I will have to cypher on this for awhile, but my first impression was this does not bode well for anyone... When did these stupid cops take medical training is the first thing that comes to mind. Privacy issues, watching a patient who needs medication suffer, cause a Doc is scared of a visit from the local Gestapo etc. Just a few things that come to mind. Stay tuned and start chewing.

I know the other side of the coin unfortunately...where this is indeed happening. I wish that I was not privy to this information. It is a sad truth though..prescription abuse is rampant in our city.
This has been an ongoing issue for many years now. I can recall before the ER was changed there used to be a list on the wall, patients were not to see this list..but from where I was standing, I could read every name on that list. I asked about it and was told it was a 'no no' list for people coming in looking for drugs.
I think Dr. Thorpe has the right answer...test everyone who is on these drugs to make certain they are taking them...however...here again is information I wish that I did not have...I do know of some who are prescribed ritalin, they sell this drug then have to re-buy it again. Makes no sense to me as to the selling in the first place, but...it is what it is.
I feel sad for the children of these people, they are the very one's who suffer the most.

GngrBrdMn wrote:I dunno, I just don't know. The idea of local cops strongarming doctors into not prescribing necessary medications is very, very worrisome to me. Yeah, there are always jackasses abusing stuff, Darwin generally takes care of them. I will have to cypher on this for awhile, but my first impression was this does not bode well for anyone... When did these stupid cops take medical training is the first thing that comes to mind. Privacy issues, watching a patient who needs medication suffer, cause a Doc is scared of a visit from the local Gestapo etc. Just a few things that come to mind. Stay tuned and start chewing.

Excellent post GngrBrdMn. I couldn't agree more. It's really too bad the physicians get caught in the middle because of these moron's who abuse the system. It really makes it bad for the folk's who legitamately need medication's and in the end it's these folk's who get treated the worst. I'm really not sure how these clown's can get away with it because if one suffers with a condition that requires medications there's generally a documented paper trail associated with the patient's. It would seem to me if someone who is scaming has no evidence such as xray's, Ct scan's, MRI's etc to back up their complaint then red flag's should automatically be raised. Medications are tracked thru Sask health to the individual so if these people are filling them to quick, to often, then chances are the med's are being sold. Perhaps Physician's should insist on patient's being tested first before handing meds over because if there's nothing medically showing up then perhaps their being scammed! It's a huge problem and unfortunately the folk's who do require the med's are the one's this hurts the most.

A doctor who has had the same patient over the years, he or she knows the health of the patient, so I don't believe that there would be many worries on that count.
There are some very busy doctor's here in the city with a heavy patient load, I understand this. And they are caring doctor's. They listen to the patient..and go from there. They can't see if this is a scam or not. But..the police do know who is scamming..and they can give these names to the doctor's for reference.
As I have said, the children of addicts suffer the most. And the addicts themselves.

GngrBrdMn wrote:I dunno, I just don't know. The idea of local cops strongarming doctors into not prescribing necessary medications is very, very worrisome to me. Yeah, there are always jackasses abusing stuff, Darwin generally takes care of them. I will have to cypher on this for awhile, but my first impression was this does not bode well for anyone... When did these stupid cops take medical training is the first thing that comes to mind. Privacy issues, watching a patient who needs medication suffer, cause a Doc is scared of a visit from the local Gestapo etc. Just a few things that come to mind. Stay tuned and start chewing.

Seig Heil and goose stepping to your local doctor.
And urine tests? C'mon patients are criminals unless you got a court order I say it's stepping way over the line - can anybody spell Canadian Civil Liberties Association.
As far as Ritalin goes too many teachers insist certain kids must receive it.

And ritalin is the drug of choice...poor man's heroin.