Opiates Addiction: Doctor Shopping Spree
By Ned Wicker
It’s a common problem in America. People seeking pain medication will go from doctor to doctor, trying to get a prescription and enough drugs to last them until the next round of doctor shopping.
There is no national data base, no means of making a positive identification on the patient, who may be using multiple aliases to gather as many prescriptions as possible, and the medical community does not necessarily talk to each other. Add to that the ever-growing glut of opioid medications on the market and you see quickly that there’s “trouble in River City.”
Tom Kertscher of the Milwaukee Journal Sentinel wrote of a 41 year-old man who had used “at least 13 aliases over an eight-year period to get prescription drugs more than 100 times from some 20 doctors throughout the Milwaukee area.” The man has a long history of this kind of abuse and the story states that the Milwaukee County DA is considering charges against the man for the “alleged doctor shopping.”
While the case pending against this man is extreme, the practice of doctor shopping is not at all uncommon. Go to any hospital emergency room and you will not have to wait long before finding a patient demanding pain relief. But the “shoppers” are different. They are not interested in pain relief, and certainly not interested in a doctor practicing good medicine. They want the prescription.
I once had an eye-opening conversation with an Emergency Room nurse who told me of the “regulars” who come in and demand drugs. “They know how to work the system and they know the law,” he said.
He later admitted that there have been occasions when the doctor just gave them something to get rid of them. This kind of abuse of prescription pain medication can lead to actual; medical emergencies, as addicts often overdose from a combination of illegal street drugs and the abuse of prescription drugs.
Doctor shopping can be a full-time business for some addicts, and the man who was the center of the Journal-Sentinel article had gone to more than 20 doctors. That’s 20 doctors and he was always seeking the same thing. He had gone to 16 different hospitals and clinics before he was finally arrested. His visits were successful, because he obtained OxyContin and other pain killers more than 100 times.
Some in the medical community are pushing hard for improved technology and shared information to deter the “doctor shopping.” The problem is without access to patient information, doctors and nurses in emergency rooms and urgent care clinics cannot check to see whether or not a patient has been given a prescription.
The other side of the story centers on the doctors themselves, those doctors who make their living giving out prescriptions for pain medication. As far-fetched as it seems, there are those doctors who lack any moral or ethical fiber and freely write scripts like sending a kid to the grocery store for a carton of milk. Every once in a while there is a story about a sleazy doctor who loses his license, only to get it back again and continue his malpractice.
People tend to focus on the law itself. The man in the story was charged with two felony counts of obtaining a controlled substance by fraud. He was also charged with two felony counts of possession of narcotics. Doctors who practice in the slimy shadows of society may or may not receive reprimand.
Why not have a national database?
My inclination is to focus on a national database and require positive identification of a patient before prescribing narcotics. Some systems give a doctor the option of checking some database, which may or may not be complete. If doctors are required to check the database, which an office assistant can do quickly, and enter their prescription data for others to check, there might be a workable system to curb the shopping.
You wouldn’t have to enter in the complete patient record, just the prescription information. Those checking the database could then see at a glance that a patient had a prescription for XYZ, the dosage, and the time period.
There will be people who will work diligently to abuse the system, who will go to any length cheat, but that sadly is human nature. People push the limits and always will go against the spirit of the law or the intent of the regulation.
We live in a nation of entitlement, and the television says if we need relief we should take a pill. We see drug abuse of this nature as a right, because we can go to the emergency room and receive treatment, even though there is nothing medically wrong with us. It happens every day.
The addict is not going to self-regulate. That isn’t going to happen. Society needs to regulate. A prescription drug database might be a tool to help fight against this kind of fraud.