Pharmacist Mack Scherler generally trusts customers who come to his downtown Oklahoma City shop to have a prescription filled, but sometimes they seem to be hiding something.
Picking up on nervousness — and possible prescription fraud — Scherler will look up those customers in the electronic Oklahoma Prescription Monitoring Program to see if they already had the prescription filled somewhere else.
“We see a lot of people who do a lot of drugs, and we see a lot of people who do too many drugs,” Scherler said.
“A lot of times they'll go from pharmacy to pharmacy.”
The Oklahoma Bureau of Narcotics and Dangerous Drugs Control started the monitoring program in 2006 to reduce prescription fraud, substance abuse and “doctor shopping.”
As of Jan. 1, all dispensers are required to use the program to report dispensing of certain narcotics within five minutes of being delivered to the customer.
Scherler, 58, said the real-time reporting will help prevent people from getting drugs from multiple pharmacies. He was a victim of one of these scams once when a man brought in a prescription from a Tulsa doctor.
The prescription was filled, and Scherler said he later found out that the doctor had been retired for a few months.
He said the man stole the doctor's prescription pad and then hit every pharmacy in the area.
“It was an all-day event,” Scherler said.
Bureau Director Darrell Weaver said doctors have given positive reviews about the new requirement.
“This is in every pharmacy in the state of Oklahoma. It's been seamless,” Weaver said.
The next step is getting more doctors to routinely check the list before issuing a prescription, he said.
According to the National Survey on Drug Use and Health, Oklahoma has the highest rate of nonmedical use for painkillers.
Weaver said he thinks Oklahoma doctors prescribe a lot of pain medication because they don't want to see anyone hurting in the community.
“People in Oklahoma are giving people. It's not like that everywhere,” he said. “I think it even trickles to our medical community.”
Since the law doesn't require medical personnel or pharmacists to look up every customer, the monitoring program is used more as a tool between practitioners, pharmacies and law enforcement agencies, said Mark Woodward, spokesman for the Bureau of Narcotics and Dangerous Drugs Control.
Woodward said the agency established its first drug-tracking program in 1990 and led the country in doing so.
The program, called OSTAR, only monitored Schedule II drugs, such as morphine and methadone.
In the past decade, prescription drug abuse and overdose deaths rose to new heights, both nationally and locally.
In Oklahoma, deaths from methadone overdoses rose 308 percent from 2001 to 2007.
Woodward said agents realized people were abusing different drugs and they needed a new system to monitor all of these prescription medications.
A law was passed in 2009 to require pharmacists and dispensers to move to a real-time system by this year.
“They're not your typical, stereotypical street-drug addict who's getting painkillers,” Woodward said.
Known as a silent cancer by narcotic agents, prescription drug abuse has contributed dramatically to the number of overdose deaths in Oklahoma.
In 2010, the state had 579 overdose deaths caused by prescribed pharmaceuticals. Hydrocodone overdoses alone caused more deaths (153) than all “street” drugs combined (136).
“This is certainly a new era of overdose. The rates of deaths overall are higher than they've ever been,” said Chris Jones, health scientist with the Centers for Disease Control and Prevention.
He said the number of overdoses due to prescription medication has exceeded the number of overdose deaths from heroin and cocaine in the past few decades.
“When you look at people who are initiating drug use, prescription drug is the first drug they use,” Jones said.