“Doctor shopping” is a term that is defined as the actions of an individual who visits multiple treatment providers or pharmacies in an attempt to obtain prescriptions for controlled substances, such as benzodiazepines or opioids. The person may then abuse or distribute these drugs illicitly. This practice is illegal, and persons who engage in it face significant risks, including legal repercussions, addiction, and overdose.
People who doctor shop will often attempt to mislead health providers into believing they need medication for legitimate medical purposes and do not reveal that they are also filling prescriptions from other doctors or pharmacies. Some physicians may suspect that a patient is doctor shopping but ignore this suspicion and write the requested prescriptions for profit.
Doctor Shopping Facts
Of all pharmaceuticals, opioids are the top target for doctor shoppers. In 2008, 1 in 143 patients in the United States received an opioid prescription from more than one health provider, a pattern that is suggestive of doctor shopping behavior. And, while doctor shoppers made up only around 0.7% of all U.S. patients who received an opioid prescription that year, they were responsible for the purchase of 2% of all opioid prescriptions, and 4% of pharmaceutical opioids measured by weight.
Recent research by the CDC (Centers for Disease Control and Prevention) examined accidental prescription-drug overdose fatalities. It revealed that 21.4% of decedents had engaged in doctor shopping just prior to their death. Doctor shopping is usually evidence of illegal distribution or prescription drug misuse, especially where opioids are concerned. It remains one of the primary factors driving the opioid addiction and overdose crisis in the U.S.
This practice is unlawful in all 50 states and Washington, D.C., and many state laws impose severe criminal penalties that can lead to long-lasting consequences for offenders. Also, nearly every state has implemented a prescription drug monitoring program (the exception is Missouri) as a method of tracking patients who receive prescriptions for controlled substances.
Who Engages in Doctor Shopping?
People who are seeking opioids are the most prevalent doctor shoppers. A 2013 study investigated opioid prescription histories to identify doctor shoppers by their dug purchasing patterns. After examining data that included more than 146 million opioid prescriptions distributed by 76% of pharmacies in the U.S., researchers identified an “extreme group” of approximately 135,000 individuals suspected of doctor shopping.
This group, on average, filled 32 prescriptions for opioids from ten different health providers over ten months, and most of these likely doctor shoppers ranged between 26-35 years of age. Overall, this extreme group obtained 11.1 million grams of opioids using this method over the 10-month period. This number is equivalent to 109 milligrams of morphine per patient per day for an entire year.
The risk of overdose is high for persons who use an average of 100 milligrams of morphine per day. According to a national sample of Veterans Health Administration patients who experienced chronic pain and received opioids between 2004–2009, those who died of opioid overdose were prescribed 98 MME (morphine milligram equivalents) per day. Other patients were prescribed about half of this amount (an average of 48 MME per day.)
A study in 2014 by the University of North Carolina and Georgia Southern University sought to shed light on doctor deception by examining its pervasiveness, motivations, and risk factors. In a random sample of over 2,300 young adults, 4% reported they had tried to deceive a doctor in an attempt to obtain a pharmaceutical drug.
Around half of those who reported deceiving a doctor said their motivation was to sell at least some prescription medication. Although, most of these persons also reported that their own problems with substance abuse were at least partly driving their behavior.
There are multiple reasons why a person would be compelled to engage in doctor shopping, including those related to mental illness (e.g., substance abuse addiction, pain, or depression). In contrast, others may be associated with continuing symptoms or discontent with the first doctor or his/her professional opinion. While the nature of these psychological disorders varies, the majority of doctor shopping incidents appear to be directly related to substance use disorders.
Common Drugs That Doctor Shoppers Target
The DEA (Drug Enforcement Administration) has identified at least four classes of drugs that are popular targets for doctor shoppers and other forms of drug diversion. Research from 2010 published in the Drug and Alcohol Dependence journal examined the most extensive electronic prescription drug monitoring program in the U.S.
It revealed that opioids were the most commonly sought after among doctor shoppers. Indeed, opioid medications accounted for nearly 13% of all prescriptions sought during multiple provider events. Benzodiazepines were second at 4.2%, followed next by stimulants at 1.4% and weight loss treatments at 0.9%.
Doctor Shopping Prevention
Although it can be challenging for healthcare providers to identify doctor shopping cases, steps can be taken to mitigate or prevent it. State drug monitoring programs that track prescriptions can help health providers and pharmacists recognize potential instances of doctor shopping or other forms of drug diversion. As noted, most U.S. states have established laws that outlaw doctor shopping. Each state also has a fraud statute that declares it illegal to obtain, or even attempt to obtain, a narcotic using fraud or misrepresentation.
Prescription Drug Monitoring Programs (PDMPs)
PDMPs require health providers and pharmacists to record each prescription medication filled in a government database. This program allows doctors and pharmacists to identify persons who show signs of addiction and may be engaging in doctor-hopping behaviors. Several credible studies have revealed that PDMPs are an effective means of discouraging doctor-shopping behavior and reducing its prevalence.
Pharmacists have significant accountability in preventing doctor shoppers from receiving controlled substances. Pharmacists are the most well-suited for identifying individuals who are suspected doctor shoppers, by watching for altered or fraudulent prescriptions and patients with multiple scripts from more than one provider. Also, many pharmacies have hotlines to inform other pharmacies in the area when a falsified prescription has been noticed.
Doctor shopping behavior is usually an indication of a substance abuse problem. Persons who engage in these harmful practices may be chemically addicted to prescription drugs, and detox and long-term rehab may be the only way to help those suffering.
Just Believe Recovery offers a comprehensive, evidence-based approach to substance abuse treatment that includes partial-hospitalization and inpatient formats. Our center features therapeutic services and activities beneficial for the recovery process, including, but not limited to, the following:
- Individual counseling
- Family counseling
- Group counseling
- Peer support groups
- Health and wellness programs
- Life skills training
- Relapse prevention
- Aftercare planning
Our compassionate, professional addiction specialists facilitate these services to those we treat with care and expertise. We are committed to providing each individual with the resources, tools, education, and support they so desperately need to achieve abstinence and experience long-term, sustainable sobriety, and wellness.
If you (or you suspect someone you know) have been doctor shopping and defrauding health care providers in an attempt to obtain controlled substances, please seek treatment as soon as possible.
Call us today to discuss treatment options. Discover how we help those who need it most break the chains of addiction so they can experience the happiness they deserve!