To follow up on that, when I was practising in British Columbia, one of the things we had was daily computer-generated information coming out of the college of pharmacists and the college of physicians. Every single day we got lists of the people who were double doctoring, triple doctoring, and all of the alias names that they gave to doctors, so that we were able to flag these people as they walked into the office.
This doesn't work in the emergency room, as you say, because you won't get it within 24 hours, but it does work to curb the practice by physicians in the office who do this kind of stuff and don't think about it, who have been pushed by patients with a sob story saying their stuff fell down the toilet, and la, la, la. You get a sense of the people who are the ones you should look for. As well, the colleges get a sense of the doctors who are very easy marks and tend to prescribe very easily.