Playing the cards ... Many people, such as Heath Ledger, have been ‘Doctor Shopping’ to obtain more medication than they need. Source: News Corp Australia

The Academy award winning actor died accidentally from a prescription drug overdose in his Manhattan apartment in 2008 after taking a mix of medicines for insomnia, anxiety, pain, and the common cold.

Between 1,300 and 2,500 Australians a year are estimated to die from similar prescription drug misuse, more than those who die on our roads.

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The medicines monitoring body NPS Medicinewise reports the number of opioid prescriptions subsidised by the Pharmaceutical Benefits Scheme (PBS) surged from 2.4 million in 1992 to 7 million in 2007.

And prescription opioids now account for 80 per cent of hospital admissions for opiod poisoning, overtaking heroin.

A 2013 Victorian Coroner’s Court report on drug overdose deaths also identified benzodiazepines, a class of tranquillisers or sleeping pills, as a key drug of concern in overdose deaths.

Struggle for reform

For more than a decade coroners have been calling for a real time prescription monitoring system so doctors could catch out doctor shopping patients and know if a patients had received a similar script from another doctor.

In April this year Victorian Coroner Audrey Jamieson recommended a “real time prescription monitoring system to prevent ongoing harms and deaths associated with pharmaceutical drug misuse”.

In June this year NSW Deputy State Coroner Carmel Forbes investigating the deaths of three unrelated people who had dangerous levels of prescription medication in their system called for a “real time web based prescription monitoring program”.

Shutting down Doctor shopping

New free medical software called Dr Shop being rolled out around Australia is an attempt to stop the doctor shopping that allows people to feed their prescription drug habits.

It allows doctors in the process of writing a script to check whether patients have been prescribed 138 dangerous drugs by other doctors on the same day or in the last 90 days.

Instead of feeding the persons drug habit the doctor can instead send them to rehabilitation.

“If a person is seeing three doctors in a morning to get prescriptions it would capture that. It is within ten seconds of being current,” says Medisecure chief executive Phillip Shepherd.

More than 700 doctors practices have signed up to use the scheme and it is working in four clinics in Victoria.

Practical effect

Paul Soloviev the clinical manager of Acland St Medical Centre says within the first week of using the software the practice identified a number of doctor shoppers.

“We have a good working relationship with a local clinic First Step in St Kilda and they are doing a marvellous job with those patients,” he said.

The key problem with Dr Shop is that it only works in conjunction with Medicsecure’s electronic prescription software used by around half the nation’s medical practices.

It does not capture prescription data from the other half of doctors who use another electronic prescribing platform.

National President of the Pharmacy Guild George Tambassis says the Guild supports “one national system, with the privacy and governance controlled and maintained by government”.

“We don’t support a multiplicity of systems run and operated by multiple private companies, especially if they exclude pharmacy,” he said.

Dr Nathan Pinksier the chair of the Royal Australian College of GPs standing committee on e-health says the problem with Dr Shop is it only provides information on prescriptions written by doctors using Medisecure software.

“We need one national data base,” he said.

“We are extremely frustrated, people are looking for an urgent solution,” he said.

The Federal Government has been trying to set up a national electronic prescription monitoring scheme and spent $3 million on the project and made licensing for it available to states in 2012 but they have not yet adopted it.

The problem with this system is it aims to collect information on opioids but not benzodiazepines which are the most commonly abused medications.