PATIENTS being given powerful painkillers should be routinely drug tested to make sure they are not selling their drugs on the booming black market, doctors say.
Leading pain and addiction medicine experts say there is increasing evidence of doctors being scammed for large doses of prescription drugs, particularly addictive opioids such as OxyContin.
While addicts ''doctor shopping'' for prescriptions is well known, the head of pain management at the Royal Adelaide Hospital, Penny Briscoe, said there was now evidence of ''fossil pharming'' in Australia where elderly people sell their medication to supplement their pensions.
Dr Briscoe said an elderly palliative care patient recently admitted to selling his drugs to boost his income, raising the prospect that more patients were doing the same without their doctors knowing.
''I think we should be screening a lot more patients than we are and if you're going to do it, you have to do it to everybody and tell patients about it. You can't discriminate on age, sex or the number of tattoos,'' she said.
The head of clinical services at Turning Point Alcohol and Drug Centre, Matthew Frei, said that while most people abusing prescription opioids were getting them from doctors for themselves, some were getting them from elderly relatives who were either selling them or passing them on.
''I certainly have seen people who say their source for the drug was an elderly relative,'' he said. ''I don't think it's extraordinarily common but it's possible we're not hearing about it.''
Another addiction medicine specialist, Philip Crowley, said urine testing patients on opioids should be standard treatment.
''There's a strong economic incentive to sell these drugs. You can sell one Kapanol [morphine] tablet for up to $80 so if you get a pack of 20, you can certainly make enough to pay your rent and power bill.''
It comes as doctors are increasingly falling prey to sophisticated scams to get large amounts of prescription drugs.
State health departments have advised doctors about various scams this year including fraudulent prescriptions and fake letters from doctors to get hundreds of OxyContin tablets from dozens of doctors.
Some people stole pages from GPs' prescription pads while they weren't looking.
Others created fake prescriptions using images on the internet, or posed as doctors.
In one extraordinary case, a Victorian man got prescriptions for anabolic steroids by calling a GP and successfully pretending to be a hospital specialist who was referring a patient (himself) to the GP to obtain the prescriptions.
''The same offender obtained more than 800 anabolic steroid injections by presenting forged prescriptions, and obtained enough testosterone to treat 87,000 sheep by convincing a veterinary practitioner that he was a sheep farmer,'' a Victorian health department document says.
Another patient has been using a fraudulent letter from an interstate medical clinic that has a number on it that connects to his female accomplice.
Health authorities say prescription opioids are increasingly becoming a drug of choice on the streets because of their purity and low cost. Sydney's medically supervised injecting centre recently reported that two thirds of its 225 daily clients were now injecting prescription opiates, especially OxyContin.
The dangerous trend appears to be causing more deaths. An analysis by researchers at the National Drug and Alcohol Research Centre at the University of NSW found 500 Australians aged 15 to 54 died of an opiate overdose in 2008, up from 360 in 2007.
Only one third were from heroin. Preliminary figures suggest there were 612 such deaths in 2009, a 22 per cent increase from 2008, and 705 in 2010, a 15 per cent increase from the year before.