Opioid Questions: What Is Doctor Shopping?
Doctor shopping is a major phenomenon affecting patients and doctors in the United States. Patients seek multiple medications from visiting different doctors and having prescriptions filled. To add to this, patients do not tell their doctors of previous doctor visits, or what medications they have been using for the past month. These medications can be for one illness they are seeking treatment for, or for several illnesses. These prescriptions range from Opioids, to Benzodiazepines, to Amphetamines and treat a wide range of medical and emotional conditions. The term doctor shopping is also called “double doctoring,” a term which is becoming more prevalent within the medical community. This term may be slightly misleading, however, as many doctor shoppers seek out many more than two doctors.
Millions of Americans suffer a dependence of prescription medications. According to a recent survey, 55% of Americans use prescription medications on a daily basis. Out of the 55% of Americans abusing prescription drugs, over 50% got such prescriptions from more than 1 doctor. Additionally, most patients had no provider review their meds. This has allowed doctor shopping to become more prevalent.
Signs of Doctor Shopping
It’s rather difficult to spot someone who doctor shops, as patients are known for lying to get more medication. Since patients visit many doctors, there may not be anyone keeping track of their visits or preferred medication. Some patients travel out of state to doctor shop to keep their activity a secret. Out of the 0.7% of American doctor shoppers, 0.40% appeared to be doctor shoppers through their behavior, while 0.5% were identified as “heavy shoppers.” There are specific signs of someone doctor shopping, which include but are not limited to:
- Faking illnesses (they may become “sick more often” than usual)
- Complaining about the medications not working
- Having 5 or more doctor shopping visits in a year and a half’s time
- Requesting stronger versions of the prescribed medication from doctors
- Stashing of prescription drugs in medicine cabinets or around their home
- Reselling prescription meds to people who may or may not be injured
- Using meds in an atypical fashion, such as crushing them up and snorting them
- Preferring to visit doctors who are lax in writing prescriptions
- Combining meds with other drugs (like marijuana, alcohol or illicit drugs)
- Patients preferring to visit doctors who are generous in writing prescriptions
The patient may also be doctor shopping to maintain a prescription drug dependence, or for non-medical use and redistribution.
Consequences of Doctor Shopping
There are several challenges and consequences associated with doctor shopping. As doctors become increasingly aware of patients double doctoring, they may be hesitant to prescribe medications to patients. Secondly, doctors who have returning patients may deny them or meds or may not trust honest patients due to lying patients.
Patients often use cash to pay for prescription meds rather than paying with insurance, allowing them to get away with multiple prescriptions. Doctors are placed in a tough position, since they want to help the patient feel better. They may listen to the patient without too much of a protest, but the patient may largely exaggerate their symptoms. Since pain in subjective, doctors may not know how much pain the patient feels.
There are legal consequences to doctor shopping. States like Florida, who lost 2,710 people in 2010 because of Oxycodone abuse, have imposed harsh laws. Patients who do not tell doctors and pharmacists of drugs they’ve taken in 30 days risk getting a third-degree felony in the state. As a result of strict laws surrounding the distribution of prescription pills and poor pain management, doctor shoppers are jailed for longer periods of time. Doctors and pharmacists are also required to report prescription drugs within a week of writing them to the Prescription Drug Monitoring Program.
Doctor Shopping’s Contribution to the Opioid Crisis
Drugs like Vicodin, OxyContin and Percocet are popularly abused prescriptions. Considering the potency of these opioids, patients opt for them when doctor shopping. Some patients have managed to get as many as 32 prescriptions from 10 different doctors. According to some estimates, doctor shoppers are responsible for nearly 2% of total Opioid prescriptions. Unfortunately, some see a dependency on prescription Opioids as something to exploit.
Counterfeit clinics have taken advantage of those dependent on prescription opioids by employing unscrupulous doctors looking for extra money. These doctors have been reportedly prescribing prescription opioids at “5 times the national average”. Despite these attempts to monetize the vulnerabilities of others, doctor shopping rates have begun to decrease, with legal interference catching people in the act.