In the United States, more than 4 billion prescriptions are filled out by pharmacies each year, for reasons varying from seasonal allergies to temporary pain from surgeries. Of those, more than 250 million are for painkillers, and more than 13 million are for benzodiazepines. While the medical community is quickly beginning to recognize that these drugs are often harmful and highly addictive, many people are left on them for months and years at a time – often with little to no drug schedule management.
This often results in chemical dependence and then psychological addiction, so that the user goes through severe mental and physical withdrawal when their supply of the drug is cut. But, alongside the rising awareness of opioid and benzodiazepine addiction, doctors are prescribing less, in lower quantities, and revising existing subscriptions.
Doctor shopping is the trend of going to multiple doctors with the same illness or problem in an effort to get multiple prescriptions for the same problem. This tactic is used by both addicts who need more of the drug to prevent withdrawal symptoms and by resellers, who look to ‘flip’ their prescription and sell it on the street.
Anti-Doctor Shopping Laws
All 50 states and the District of Colombia have some form of an anti-fraud statute which reflects anti-doctor shopping regulation. Most have adopted some form of the Uniform Narcotic Drug Act of 1932 (or Uniform Controlled Substances Act of 1970) that “A person shall obtain or attempt to obtain a narcotic drug or procure or attempt to procure the administration of a narcotic drug by fraud, deceit, misrepresentation, or subterfuge, or by the concealment of a material fact”. Under this statute, doctor shopping is very illegal and prosecutable by law.
In addition, 20 states have specific anti-doctor shopping laws. Sixteen also require that doctors prescribing opioids consult with a prescription database to ensure that the person has not received prescription painkillers from another doctor. These Prescription Drug Monitoring Laws include databases covering up to 29 states and, once a doctor has given a prescription, they enter it into the database. If a person is cross-referenced as having prescriptions from multiple doctors, the DEA is notified and that person is ‘flagged’ in the database.
How Many People Doctor Shop?
Data shows that anywhere from 5.5 to 56% of patients doctor shop depending on the doctor and the illness. In some cases, doctor shopping is a very straightforward attempt to obtain a substance for illicit use. In other cases, the factors behind doctor shopping are more complex, and may reflect dissatisfaction with a doctor or the effects of a prescription, a doctor being unavailable to refill a prescription when it is needed, or even inter-family relationships, where emotional problems (such as two divorced parents taking their teen to two different doctors) result in doctor shopping. Therefore, the prevalence of doctor shopping changes quite a bit based on demographics, and a high rate doesn’t necessarily correlate to illicit use.
In most cases, opioid painkillers such as codeine, morphine, dihydrocodeine, methadone, buprenorphine and diamorphine are most commonly obtained by fraud. Others doctor shop for drugs such as Vicodin, Xanax, or Valium. In most cases, narcotics are the popular target, with some studies showing that they are obtained via doctor shopping much more frequently than other drugs. In fact, one study showed that an average of 0.7% of all opioid patients doctor shop, but in 2010, this small group (of about 135,000 people) obtained as many as 32 prescriptions each from as many as 10 different doctors. While new laws and databases are making this sort of rampant abuse more difficult, a very small percentage of ‘shoppers’ greatly skew the total statistics.
What Happens If You Get Caught?
If you or a loved one is caught doctor shopping, repercussions can be severe. Depending on the state and the extent of doctor shopping, criminal punishment can vary from a small fine to a several hundred thousand dollar fine and several years in prison. More often, the person caught doctor shopping will be flagged by the DEA where they will be pushed into a diversion program to serve time in rehab instead of going to prison. Here, most will attend a minimum of 28 days of rehab and will serve community service, while spending time with a caseworker. After completing any sentence, the person caught doctor shopping will remain red flagged, which means that they are listed in pharmacy databases, typically need a single approved pharmacy to fill prescriptions, and most likely cannot fill prescriptions early.
Most states consider doctor shopping to be a very serious offense, and without proof of a personal addiction, the person being caught may be prosecuted for fraud with the intent to sell illegal substances as well.
Doctor shopping is illegal and you can be prosecuted, which leads many people to avoid seeking out help. However, if you go into rehabilitation, you are protected. The Health Insurance Portability and Accountability Act (HIPAA) mandates that a physician or healthcare provider must keep your data confidential unless your actions have or are currently harming another person or you are planning to commit a felony and their revealing the information will prevent it. Providing you stop doctor shopping when you go into treatment, you are protected by the law because the law wants you to recover.
This means that you can take your loved one to rehab while they are illicitly obtaining substances, because the doctor will protect their privacy and security.
Prescription drug abuse is an addiction, and like any other substance dependence, requires treatment. This is especially important as stricter prescription drug regulations make it more difficult and more expensive for addicts to get their drugs through official channels – leading to purchasing on the street and shifting towards cheaper and potentially more dangerous heroin.
Getting an addict into treatment will enable them to withdraw safely, learn coping skills, and go through cognitive behavioral therapy (or a similar therapy) to recognize and tackle the problems behind their addiction. More importantly, it will put your loved one on the pathway to recovery, before they face legal problems (or worsening legal problems), or health problems.
Good luck getting your loved one into recovery.
If you or someone you love is struggling with drug addiction or alcoholism, or you just have questions, please call Lighthouse Treatment Center today. We are happy to provide a no-cost, no-obligation consultation with one of our experienced treatment advisors. Help is available today.