Star Deaths Raise Questions About 'Pharmacy Shopping'

Dec. 24, 2009 — -- The number of prescription medications reportedly found at the home of actress Brittany Murphy after her death this weekend highlights the failure of federal prescription drug regulations, according to at least one forensic pathologist.

"How are these people getting four or five drugs each with a psychotropic component?" said Dr. Cyril Wecht, a forensic pathologist who worked on the Anna Nicole Smith case. "Where is the federal government? Where are the state regulations? Who is prescribing these drugs, and why are they being prescribed so indiscriminately?"

Los Angeles Assistant Chief Coroner Ed Winter told ABC News.com that several legal prescription medications -- all made out to Murphy -- were recovered from her apartment and taken in as evidence. Additional messages left for Winter by ABCNews.com to obtain specific drug names found in Murphy's home were not immediately returned.

According to TMZ.com, which cited notes obtained from the Los Angeles Coroner's office, as many as nine prescription medications -- some of which could have proved harmful if not fatal had they been combined incorrectly -- were found in Murphy's home, including anxiety drugs Klonopin and Ativan, and pain relievers Hydrocodone and Vicoprofen.

Dr. Bruce Goldberger, the director of toxicology at the University of Florida College of Medicine, did not treat Murphy but said the drugs reportedly found in the actress's home would indicate that the star may have been treated for "depression and anxiety, and possibly migraine headache and bipolar disorder."

"If these medications were misused or abused, this could result in central nervous system depression, leading to somnolence, coma and death," said Goldberger.

But Murphy's husband, Simon Monjack, is refuting rumors that his late wife may have been incorrectly using drugs or that she had been suffering from health problems.

"She was on herbal remedies that wouldn't speed up her heart," Monjack told People magazine Tuesday, explaining that on the day prior to her death Murphy had been suffering from laryngitis. "There was nothing here that could endanger her; there was prescription medication in the house for her female time and some cough syrup. That was it."

Monjack also told the magazine that his wife had suffered from a heart murmer that was known to cause fatigue, dizziness and irregular heartbeats.

When asked if a drug overdose could have caused her death, Monjack responded: "I can get rid of that one right now."

Murphy is the latest in a string of celebrities who have been found to be in possession of prescription medications when they died. In addition to Smith, who died of an apparent drug overdose in a Florida hotel room in 2007, actor Heath Ledger and music icon Michael Jackson were found with prescription medications in their names at the time of their deaths. Celebrity DJ Adam Goldstein, also known as DJ AM, also had a variety of painkillers and anti-anxiety medications when he was found dead from an apparent accidental drug overdose in August.

Though there is no evidence to suggest that all of those stars illegally obtained the drugs found in their possession, Wecht believes that the more celebrities who reportedly die surrounded by prescription medication bottles, the more likely it becomes that action will be taken to improve oversight of the practice called "doctor shopping" or "pharmacy shopping," which is when people seeking drugs go to several doctors or pharmacies who don't know their medical histories and might be more inclined to arbitrarily prescribe medications.

"I don't think this would be a hard thing to fix," he said. "These celebrity deaths, regrettably, they provide the impetus for change."

Former Drug Addict Describes Ease of Getting Prescription Meds From Docs

Rick Kirkham, a journalist who battled drug addiction for nearly 20 years, told ABCNews.com that it was "extremely" easy for him to get prescription drugs when he was using.

"These days, if you go to a doctor all you have to do is ask for whatever drug it is that you've taken before, and the doctor will likely give it you. I've gone through that experience myself when I was doing drugs," said Kirkham, who has been drug-free for 10 years but said acquaintances who still use drugs tell him similar stories of easily accessible prescription drugs.

Kirkham said that he would ask friends for doctor recommendations so he could ask different medical professionals for different prescriptions without one getting suspicious, a typical "doctor shopping" practice.

He even learned which pharmacies would cross check his medical record before giving him a prescription.

"Certain pharmacies like [big chains] have a computer system where they can double check what else you're taking," said Kirkham. "So then I'd just hit the little mom and pop pharmacy, they don't have the same system" that cross checks your other prescriptions.

Thirty-three states currently use computer systems like the one Kirkham described, called a Prescription Drug Monitoring Program, or a PDMP, according to the Drug Enforcement Administration. The databases collect prescription data from pharmacists and prescribers as they are dispensed and allow public health officials to keep track of the controlled substances prescribed in the state, according to the National Alliance of Model State Drug Laws.

California is one of the states that has a PDMP, spearheaded by Attorney General Jerry Brown, who said in a statement that the deaths of stars like Smith and Jackson have "made it clear to the whole world just how dangerous prescription drug abuse can be."

Brown helped launch an Internet-based prescription monitored database that he hopes will make it easier to "track patients' prescription-drug history." According to Brown, the updated online system will replace the slower, less efficient system the state previously used in which mailing or faxing written requests for information would be required to get more information on a patient's previous prescriptions.

HIPPA Limits Pharmacists' Access

But Kirkham and others don't think the improved computer tracking systems are not enough, and argue that change needs to be made on a national level.

"I don't think the regulation of prescription drugs right now is working at all," he said. "I can tell you it's a lot easier for kids to get pharmaceutical medicines than it is to get a pack of cigarettes or a six-pack of beer.

"The DEA has to be the one to control and figure out a way not only to identify doctor shopping, but pharmacy shopping," said Kirkham.

DEA spokeswoman Dawn Deardon said that while there is no national system, states are free to work together to try to curb prescription drug abuse.

"Though there is no national database, states can work together to develop a network of PDMPs," Deardon said.

Wecht suggests a federal policy that would allow pharmacists privileges similar to the ones doctors have when it comes to sharing patients' medical histories. The Health Insurance Portability and Accountability Act, or HIPPA, might need to be adapted, said Wecht, to allow some information to be shared in cases where doctors are administering prescription drugs. HIPPA was developed to ensure and protect patient privacy.

"Pharmacists should be able to know that a person is getting a drug there and a drug here, and the federal government needs to step up to the plate," said Wecht. "When you have a drug prescribed to you, then you should also be giving permission to your pharmacist to check into the records to see what other drugs you're on."