Addicts no longer have to go into dark alleys or under bridges to score drugs.

Now they try to scam health care professionals, often hopping state lines to do it.

Police say some physicians “freely” prescribing controlled substances have contributed to West Virginia’s prescription drug abuse problem. However, many addicts working to fly under the radar are crossing multiple state lines, both visiting physicians and filling prescriptions in multiple states.

A federal prescription database, they say, could flag potential “doctor shoppers,” no matter what state lines they cross.

Whether the prescription drug traffic begins locally or out of state is debatable.

Detective Lt. Gant Montgomery, field supervisor for the Beckley Police Department narcotics unit, said the majority of illegal prescription drug sellers legally obtain medication from local physicians. Some of those physicians, he said, will freely prescribe the drugs for pure profit or give them to patients in return for sexual favors.

He noted West Virginia is the No. 1 state in the nation for prescriptions dispensed. While there is a large elderly and disabled population, he pointed to the number of pharmacies in Beckley alone. Sometimes, there are multiple pharmacies in one city block.

“I believe the situation is lax, with some doctors prescribing drugs like oxycodone and ones of that nature, freely,” he said.

But people obtaining their prescriptions out of state, primarily Florida, have become a major issue as well, Montgomery said.

Raleigh County Sheriff Steve Tanner said pharmacy burglars or local physicians excessively prescribing controlled substances are not the leading contributors.

Most of the illegal prescription drug traffic, he said, begins in other states, particularly Florida. In that state, several physicians operate clinics in strip malls. Drug users or those who plan to sell the medications can generally go in and have a controlled substance prescription in hand within a half hour.

“Florida is the worst,” Tanner said. “We are inundated with people going to Florida. They’ll load up a van with six or seven people, go down I-77 and go through North Carolina, South Carolina, Georgia, Florida. They’ll stop at every strip mall clinic, all line up and leave with various prescriptions. Then they have prescriptions filled at pharmacies in different states on their way back up.”

The strip mall clinics are convenient because those wanting prescriptions can often visit multiple clinics in one mall, Tanner said. Some will get to an out-of-state location, find addresses in a phone book and plan their routes.

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West Virginia and several other states have statewide prescription databases. These show what prescriptions a person has filled in that state. They are designed to identify possible “doctor shoppers” — people who go to multiple physicians and/or pharmacies to obtain large amounts of the same medication.

Privacy concerns stalled some attempts to create such a database in Florida, and it became the largest state without one, according to the Miami Herald. Investigators said that made Florida a prime destination for drug dealers and addicts from across the nation.

The Florida State Senate passed legislation last spring that would create such a database for that state and Gov. Charlie Crist signed it last June.

Work on the Florida state database is under way, but it is not active yet, according to Crist’s office.

Tanner believes a national prescription database could seriously combat the problem. Individual states could start their own prescription databases, but a national database would require federal government intervention.

“I am against large government, but you have some people visiting six pharmacies in Florida and three more in South Carolina,” he said. “With a national database, someone could see this is the fourth or fifth pharmacy someone has visited. This would be most especially helpful when someone is filling prescriptions for the same medication. If there are six different doctors prescribing the same person OxyContin, that should be an issue.

“It does raise questions when you have the same people filling these prescriptions over and over again.”

Some people do have to visit out-of-area or out-of-state specialists, and people often have prescriptions filled out-of-state while on vacation, Tanner said. But the database could zero in on people who are clearly raising red flags.

Tanner said his agency has an excellent working relationship with the West Virginia Board of Pharmacy and that local physicians are extremely helpful and concerned about the problem. On the other hand, he said, physicians in larger cities do not have the more personal relationships with patients as do those in West Virginia. These physicians are more likely to try and process patients in the most expedient fashion.

— E-mail: apridemore@register-herald.com