Helen Jennens flips through two sets of documents 害羞草研究所� one for each son who fatally overdosed.

Letters she sent in both cases to the College of Physicians and Surgeons of British Columbia alleging the careless prescribing of potentially dangerous medications are neatly organized among responses from doctors.

Jennens says the deaths of her sons, Rian Leinweber in August 2011 and Tyler Leinweber in January 2016, could have been prevented if doctors had checked their drug histories on B.C.害羞草研究所檚 unique real-time database PharmaNet.

The provincewide network links pharmacies and hospitals to a central database that stores information on all dispensed prescriptions. The system is also available to physicians, but doctors say most do not use it.

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Jennens, who lives in Kelowna, has asked the college to make use of PharmaNet mandatory for all doctors so the files of high-risk or drug-seeking patients are flagged.

害羞草研究所淏oth boys, I have no idea how they lived as long as they did, with the medications they were prescribed, the combinations they were prescribed,害羞草研究所� Jennens says through tears.

Rian was 37 when he died, three years after a truck collided with his motorcycle, crushing his right leg from hip to toe, requiring multiple surgeries.

Jennens went to Rian害羞草研究所檚 home with a pot of chili and found him propped up on his bed with his computer on his lap. He害羞草研究所檇 stopped breathing from a combined overdose after being prescribed benzodiazepines, various drugs for insomnia and depression, and opioids for chronic pain while he awaited a second hip replacement.

Jennens says she害羞草研究所檇 warned doctors Rian could become hooked on opioids because he害羞草研究所檇 endured a decade of addiction that included cocaine and crystal meth.

害羞草研究所淗e was eight years drug free when he got into that accident. I said, 害羞草研究所榃e know legitimately he needs stuff for pain because his leg was shattered but we also have to stay on top of it.害羞草研究所� 害羞草研究所�

After Rian died, Jennens requested his PharmaNet records and questioned why he was prescribed such a wide range of medications including opioids.

害羞草研究所淲hy didn害羞草研究所檛 these people say enough? That was my whole issue with PharmaNet,害羞草研究所� Jennens says. 害羞草研究所滻t lets you know somebody害羞草研究所檚 got a drug history. He害羞草研究所檚 on this cocktail for three years and nobody is concerned about what may happen in terms of overdose?害羞草研究所�

A big part of Jennens害羞草研究所檚 complaint with the College of Physicians and Surgeons focuses on mandating the use of PharmaNet, which she says could be optimized to protect patients.

害羞草研究所淭hat didn害羞草研究所檛 happen, and five years later, my second son died,害羞草研究所� she says of Tyler, who had ruptured his left Achilles tendon in 2008 while playing football and was prescribed OxyContin.

He became addicted to heroin and unknowingly took what turned out be fentanyl in his ex-wife害羞草研究所檚 bathroom, where he was found dead on the floor. A coroner害羞草研究所檚 report says he had overdosed on the powerful opioid.

害羞草研究所淗e used to lay in my lap at night and say, 害羞草研究所楻emember when I played football? Why can害羞草研究所檛 I get that back?害羞草研究所� 害羞草研究所� Jennens says. 害羞草研究所淗is sister saw him twice in the last three years of his life because she wouldn害羞草研究所檛 subject her daughter to his behaviour, and it killed him. It害羞草研究所檚 killing her now.害羞草研究所�

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Armed with 173 pages of PharmaNet records listing Tyler害羞草研究所檚 medications, Jennens filed a second complaint and 害羞草研究所減leaded害羞草研究所� with the college to make the use of PharmaNet compulsory for all doctors.

Jennens害羞草研究所� first complaint to the college resulted in one doctor being directed to take two continuing medical education courses on the responsible prescribing of opioids and strategies to manage chronic pain through less reliance on drugs.

Her complaint after Tyler died was forwarded by the college to 20 doctors who were cited for their prescribing habits. In their response letters, some doctors say they did not access PharmaNet, while others say Tyler害羞草研究所檚 death prompted them to use it.

Dr. David Hawkins says in his letter that the medical system allowed Tyler害羞草研究所檚 family to suffer 害羞草研究所渁s a result of his death, and that was quite possibly avoidable. Certainly his medical encounters did not present him with treatment that could have offered him a way out of his situation.害羞草研究所�

Hawkins also offered an apology: 害羞草研究所淚 am sorry for the part I played in Tyler害羞草研究所檚 death and for not addressing his anxiety in an alternative manner at that time. I hope that the changes by both myself and the rest of the medical profession can help to tame this terrible crisis.害羞草研究所�

In an interview, Hawkins says using PharmaNet while treating addicted patients with chronic pain is time consuming, especially because it害羞草研究所檚 not linked with electronic medical records so doctors must use different systems to get information about any tests and consultations.

害羞草研究所淭o try to compare any one visit with another in the past is really challenging, and that害羞草研究所檚 before you even see the patient so you害羞草研究所檙e exhausted by the time you even enter the room,害羞草研究所� says Hawkins, who works in Lake Country, B.C.

害羞草研究所淚t could be done electronically, if someone were to program these systems properly,害羞草研究所� he says. 害羞草研究所漌e need certain things and we害羞草研究所檙e just not getting them. I害羞草研究所檓 not pretending that it would be easy but there doesn害羞草研究所檛 seem to be any effort to make our jobs easier on the front lines.害羞草研究所�

Patients suffering from anxiety and depression also require more mental health support so drugs are not the 害羞草研究所渆asy害羞草研究所� answer, he says.

害羞草研究所淚t害羞草研究所檚 really sad, with so many young people dying, older people too. Fathers, mothers. It害羞草研究所檚 horrendous what害羞草研究所檚 going on,害羞草研究所� he says of the opioid epidemic that claimed 1,422 lives in British Columbia alone last year, mostly due to street drugs, not prescription medications.

In the end, the college required one of the doctors, not Hawkins, to take a continuing medical education course in Tyler害羞草研究所檚 case.

害羞草研究所淚t is the college害羞草研究所檚 expectation that each of these physicians will use this difficult case as an opportunity for further learning and professional growth for the benefit of future patients and their families,害羞草研究所� Dr. K. Shaw of the complaints and practice investigations害羞草研究所� inquiry committee wrote to Jennens in a letter dated Jan. 16.

The college told Jennens in a letter a year earlier that if it decided a doctor had 害羞草研究所渕ade an isolated error in judgment,害羞草研究所� it would take remedial, not disciplinary, action.

害羞草研究所淚害羞草研究所檓 not out on a witch hunt for doctors,害羞草研究所� Jennens says, adding her years of lobbying is aimed at the college and the government to prevent the overprescribing of potentially addictive drugs.

害羞草研究所淒octors now thank me for bringing this to their attention,害羞草研究所� she says. 害羞草研究所淭hey agree we need to do more about PharmaNet. Why didn害羞草研究所檛 they just think about this before Tyler died? Why didn害羞草研究所檛 someone search his PharmaNet records? Fifty pages of methadone and suboxone prescribed. They had to know it was drug-seeking behaviour.害羞草研究所�

In June 2016, as part of revised standards for prescribing drugs that could be misused, the college made the use of PharmaNet mandatory at walk-in and methadone clinics.

Dr. Heidi Oetter, the college害羞草研究所檚 registrar and CEO, says the prescription monitoring system was 害羞草研究所渂est in class害羞草研究所� compared with any other in Canada.

However, she called PharmaNet 害羞草研究所渃lunky害羞草研究所� and says its ultimate success will require government officials to consult doctors 害羞草研究所渢o really make it operational in their offices.害羞草研究所�

害羞草研究所淲e害羞草研究所檙e committed to making access to PharmaNet mandatory once everybody can easily access the system,害羞草研究所� Oetter says.

Neither Health Minister Adrian Dix nor Mental Health and Addictions Minister Judy Darcy were available for interviews.

Dr. Trina Larsen Soles, president of Doctors of BC, the association that represents physicians, says PharmaNet should be enhanced to connect with medication records from hospitals, the BC Cancer Agency, the renal program and the HIV-AIDS program.

害羞草研究所淚害羞草研究所檝e got a cancer patient who害羞草研究所檚 on various chemotherapy cocktails and pain meds and I don害羞草研究所檛 know what chemo they害羞草研究所檙e on because it害羞草研究所檚 not on PharmaNet. I have to go to a different window to get that information,害羞草研究所� she says. 害羞草研究所淵ou害羞草研究所檙e doing all this on the screen instead of talking to the patient in front of you.害羞草研究所�

Dr. Tom Perry, an internal medicine and clinical pharmacology specialist at the University of British Columbia Hospital, was a New Democrat member of the legislature when PharmaNet was launched in 1995.

害羞草研究所淲hat an incredible resource,害羞草研究所� he says. 害羞草研究所滶veryone should have done it in Canada long ago, and we all should be hooked up to it.害羞草研究所�

害羞草研究所淚f my records aren害羞草研究所檛 perfect, PharmaNet rescues me or anybody else because PharmaNet not only tells you what I prescribed but it tells you what害羞草研究所檚 more important, which is did the person fill (the prescription)?害羞草研究所�

Dr. Corinne Hohl, an emergency room doctor at Vancouver General Hospital, says installation fees and monthly charges also deter doctors from registering for PharmaNet.

害羞草研究所淭his is a big disincentive, I am told, is to pay, and physicians who are private entrepreneurs in private offices simply don害羞草研究所檛 want to have to pay the additional fee,害羞草研究所� she says.

害羞草研究所淚t害羞草研究所檚 very beneficial, especially in the context of the current opioid crisis, where we害羞草研究所檙e trying to be very careful about prescribing opioids. We want to make sure that the patient is receiving opioids consistently from the same provider as opposed to eight different providers from eight different hospitals if they害羞草研究所檙e doctor shopping.害羞草研究所�

Camille Bains, The Canadian Press