Doctor David Carver serves on the front lines of the new war on drugs. In the ER at Baptist Easley he sees pill seeking addicts and street level dealers looking for more supply.
"Many a day. It's one of the most difficult things we see because it takes up so much time and we want to do what's right for the patient," Carver said.
Prescription drugs now account for more overdose deaths that all illegal drugs like cocaine and heroin combined.
A scathing new report from South Carolina's Inspector General points the blame squarely at doctors who over prescribe saying "at the core, this is a supply problem."
According to the report, Greenville County narcotics officers have "identified at least 7 physicians who are suspected of acting as pill mills where abusers and shoppers easily obtained drugs." Most, "are a cash only business."
The same report shows Union County is a destination for drug tourists from other Upstate counties.
"Two doctors appeared to be more blatant by attracting abusers and shoppers traveling from surrounding counties," the report said.
Sheriff David Taylor, of Union County, knows exactly which doctors the report references.
"We've known for quite a while who they are. We haven't been able to do a whole lot about it. We've asked for help on the state level to monitor the amount of pain medication that they're distributing but we haven't gone far there," Taylor said.
Doctors do have access to those tools but they aren't required to use them.
In places like Baptist Easley, doctors use a statewide system that tracks patients and prescriptions. The patient monitoring program, PMP, helped doctors in Pickens County ERs cut painkiller prescriptions by 50%.
Because the system isn't required, only 22% of South Carolina doctors use it.
The Inspector General recommends making it mandatory. That way, the report said, the state could track pill shoppers who go from doctor to doctor for new supplies. State agencies could also track doctors who wrote an exceptional number of prescriptions.
"That's our primary directive here is to alleviate pain, but we need to make sure we don't facilitate a chronic pain and abuse of those medications," Carver said.