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The physicians are lobbying for some $55 million in funding for the National All Schedules Prescription Electronic Reporting Act. Initially proposed by a doctors' group, the act calls for awarding grants to states to establish or improve programs to electronically monitor the dispensing of controlled substances, everything from medical marijuana to steroids and amphetamines.
The hope is to establish a coordinated national database that would show physicians across the country when patients are "doctor shopping" -- that is, obtaining prescriptions for the same medication from a number of practitioners.
Though the act was passed unanimously by both houses of Congress in 2005, it has received minimal funding -- something many blame for not only allowing unchecked doctor shopping in the U.S. but also for contributing to an estimated 20,000 deaths each year from prescription drug overdoses.
And other stats seem to back up the physicians' concerns. A recent report by CNN, citing research from the American Journal of Preventive Medicine, showed hospitalizations for poisoning by prescription opioids, sedatives and tranquilizers jumped an estimated 65 percent from 1999 to 2006.
Doctor Shopping
When addicts can't get their hands on enough drugs from one physician, their solution is often a simple one: visit numerous doctors, collect dozens of prescriptions and then have them filled at different pharmacies.
"This is common practice among drug addicts everywhere in the U.S.," confirms forensic consultant Dr. Park Dietz, founder of Park Dietz & Associates in Newport Beach, Calif.
"It is very simple for drug seekers to go to doctors in different towns, manufacture complaints or find a story that is effective and use that story -- true or not -- to be able to get a prescription for narcotics," Dietz explained.
Their hunt is made even simpler, he added, "if they have been tipped off about which doctors are 'easy' or they happen to stumble on one of the easy ones, who liberally give large quantities of controlled substances with no skepticism."
Where do these drug-seeking doctor shoppers come from? According to Dr. Gary Brazina, a board-certified orthopedic surgeon in California, addicts often start out as legitimate patients who want treatment for pain.
"Not everybody who is using a lot of pain medication is an addict," said Brazina, who serves as the team physician for the L.A. Clippers and the L.A. Kings. "Unfortunately, a lot of doctors will give so many pain medications to get a patient out of their hair that before you know it, [the patient] is on this pain medication for a year, and then you have a real problem."
Dr. Jayson Hymes, an anesthesiologist and addiction specialist, agrees that doctors share some of the blame.
"The way our health care system has grown and our cultural psyche has developed, we really have a quick fix for everything," said Hymes, medical director of a private group practice in Los Angeles. "We are a pill-taking society, and pain management has become a pill mill.
"No one wants to treat [his] back pain by losing weight and getting more exercise. That's just too damn much work," Hymes continued. "It's much easier and more fun to take a pill."
Hymes, whose practice sees a number of celebrity clients, said that while doctor shopping is a mainstream problem, it usually gets national attention only when a star is involved. He also pointed out there can be significant differences in the way celebrities access the health care system, compared with members of the general public.
"If you're a celebrity, you tend to surround yourself with people who give you approval and provide services for you, so very few people are going to say no to you," Hymes said. "If you are somebody who has various needs and desires, whatever they may be, it is the job of those people to keep you happy and satisfied.
"They'll give you things you want whether you should have them or not, because if they don't, you'll find somebody else who will, and they'll be out of a job."
Celebrity Deaths
It's little wonder, then, that the issues of doctor shopping and prescription drug abuse have cropped up in a string of recent celebrity deaths.
- Anna Nicole Smith -- The actress and former Playboy Playmate, 39, was found dead in a Florida hotel on Feb. 8, 2007. A police investigation found that Smith died of an accidental drug overdose, ingesting several medications allegedly prescribed by different doctors.
- Heath Ledger -- The actor, 28, died in his New York City apartment on Jan. 22, 2008, from what authorities say was an accidental "toxic combination of prescription drugs." The U.S. attorney's office in Manhattan later closed its investigation because it was unable to determine exactly where Ledger had obtained some of the drugs, making it impossible for prosecutors to focus on a "viable target."
- Corey Haim – The '80s teen heartthrob was found unresponsive in his Hollywood Hills home on March 10. After being transported to a local hospital, the 38-year-old actor was pronounced dead. Police initially said his death appeared to be an accidental overdose -- and in fact it later emerged that Haim had used aliases to procure more than 500 prescription pills in the month before he died. However, the coroner's office ultimately ruled that Haim had died of natural causes.
- Michael Jackson – The superstar pop singer, 50, was found dead in his L.A. mansion on June 25, 2009. Two months later, the coroner declared Jackson's death a homicide caused by a combination of drugs. According to the website TMZ, Jackson had used a number of aliases to secure prescription drugs, and during the course of the police investigation, the Drug Enforcement Administration focused on at least five doctors who had allegedly prescribed drugs to Jackson. Thus far, though, Jackson's personal physician, Conrad Murray, is the only person accused in the case. In February he was charged with involuntary manslaughter, to which he has pleaded not guilty. The case is pending.
"I can't really comment on this specific situation," Hymes said. "But speaking hypothetically, some celebs may be known for wanting medicines and practicing in a way you don't feel comfortable with, so there's not much point in going down that road."
The Legal Side
While some say the federal prescription-drug monitoring act could be the "be-all and end-all" to solving the problem, Hymes said if it doesn't get enough funding, the epidemic of prescription-drug abuse will only grow.
"The budget crisis has made it so that the [national] monitoring system is not complete," he said. "The downtime that exists [means] getting the responses is not instantaneous -- it can take days or weeks" for physicians to get information on a suspected doctor-shopping patient.
Despite the bugs in the monitoring system, though, the DEA says it has made dealing with doctor shopping a top priority. When AOL News contacted the DEA for this story, officials at the Washington office were unable to comment. However, a spokesman did say, "Doctor shopping is one of the primary ways we see pharmaceuticals being diverted. It is extremely prevalent in Los Angeles, as I am sure it is nationally."
In addition to looking for patients who are doctor shopping, authorities are cracking down on any physicians who knowingly participate in their scam, said Steve Cron, a criminal defense attorney from Santa Monica, Calif.
"If you look the other way and give prescriptions to people when you should know there is a problem or you reasonably should have known, then you are facing criminal prosecution," he said. "And you're probably going to wind up in prison."
