Multiple pharmacies, multiple prescribers.
Professionals say those are the red flags to look for to stop doctor-shopping and prescription pill abuse in Tennessee, a state under siege because of opioid abuse.
According to the Tennessee Bureau of Investigation, America makes up 4.6 percent of the world's population but consumes 82 percent of the world's opioids.
Here in Tennessee law enforcement is teaming up with medical professionals to try to curtail prescription drug abuse.
At the University of Tennesee Medical Center's outpatient pharmacy a digital tool is helping pharmacists identify people looking to abuse drugs.
"It's not surprising to me because I see it every day. I know firsthand how bad the problem is, but I do think the database is helping,” said UTMC pharmacist Ashlee Hawkins.
The Controlled Substance Monitoring Database allows pharmacists to see a patient's history and verify that the prescription in front of them is legit.
The program started back in 2002. But legislation last year really beefed up the amount of times dispensers had to turn information in to the database.
Hawkins explains not every patient needs to be looked up.
"More than a seven-day supply for a narcotic or a benzodiazepine and we'll do it for new patients that present to our pharmacy,” explains Hawkins.
In the past, pharmacists had to call insurance companies to get more information on a patient.
Now, pharmacists are expected to turn away anyone they suspect of abusing drugs.
"That conversation has happened before, it is a tough conversation. You just have to let the patient know why you're not filling the medication and send them on their way,” said Hawkins.
That's exactly what the TBI likes to hear. Special Agent in Charge Tommy Farmer leads the state's dangerous drug task force. Farmer says opioids are still a big problem for Tennessee and the country, but resources like the CSMD are making a difference.
"We've reduced the number of prescriptions over the last four to five years for morphine equivalents. They're down between 14 and 20 percent. That's tremendous progress,” said Farmer.
Hawkins says she uses the database 20 to 30 times a day, saving time and keeping drugs off the street.
"We can go in this database and it's all right there for us,” said Hawkins.
One trend the TBI is continuing to keep an eye on: prescription pill abusers switching to heroin. Meanwhile, overdose deaths from heroin and fentanyl continue to rise in the state.