1) Doctor shopping involves patients visiting multiple physicians to obtain prescription drugs illicitly or continue abusing medications. It is a major contributor to the rise in prescription drug overdoses. 2) Rates of doctor shopping vary widely in studies but can be as high as 56% based on definitions. Patients seek multiple prescriptions to build up tolerance or fill the same prescription at different pharmacies to avoid suspicion. 3) Reasons for doctor shopping include psychological dependence on drugs, lack of treatment improvement or understanding, and factors like long wait times or strict physicians that push patients to seek care elsewhere. Monitoring programs and education can help address this problem.

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Doctor Shopping – Big Problem for Police and Doctors
Thursday, Jan. 16th 2014
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Many of us look for the best possible deal on clothing, food
and shoes – “shopping” may mean going in and out of
different stores to see where you can get the best deal.
However, many people struggling with prescription drug
addiction are doing a different type of “shopping” – doctor
shopping. Over the last few years, the number of deaths
attributed to prescription drug overdoses has increased
dramatically. Many of the 36,000 people who died because
of drug overdoses in 2008 across the nation passed away
because of the misuse of prescription medications.
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Most people know that prescription medication oftentimes comes with a number of side
effects and may even be dangerous. So how is it possible that this many people are having
issues with medication that is provided by a pharmacy and recommended by a physician?
The answer here is once again – doctor shopping.
What is Doctor Shopping?
Doctor shopping means that the same patient is going to a number of different physicians
with the same purpose: to procure prescription drugs illicitly or to continue abusing
medication for a continuing illness. Depending on the literature, the definition of “doctor
shopping” may change somewhat, but the constant is that these patients are seeking out
more than the recommended amount of medication, often opioid painkillers.
If people build up a tolerance to a certain substance, they need to ingest more of the same
substance in order to get the same desired results that they experienced before. However, a
physician is only going to prescribe a specific limit when it comes to medication – especially
the type of medication that may lead to dependency. In order to get the substances they
want without arousing suspicion, this means that the user may visit several doctors in order
to get a new prescription or they will try to fill the same prescription in several different
pharmacies.
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How Prevalent is Doctor Shopping?
When looking at the different studies that discuss doctor shopping, it is important to
understand that dependent on the study methodology (most importantly, the definition of
what doctor shopping means) the rates in differing studies can range anywhere from 6.3
percent to 56 percent. It is important to understand that these percentages are moderated,
at least partially, by the study setting, the characteristics of the patient sample, and/or the
investigators’ definition of doctor shopping. However, even in low estimates, researchers still
find that people who actively engage in doctor shopping filled an estimated 4.3 million
prescriptions for opioid drugs such as Vicodin and OxyContin in 2008.
Why Do Patients Engage in Doctor Shopping?
While much of the existing literature discusses the problem in different ways, it is possible to
divide the patient justifications for this behavior into two general categories: patient-related
factors and physician-related factors.
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2. 1. Patient-related factors, psychological dependence – We can attribute a large percentage of this
issue to substance misuse/abuse. Visiting several different doctors has long been an illicit method
of acquiring opioid painkillers and other medications. A Norwegian study highlighted the
relationship between the prescription of addictive drugs and the number of physicians consulted.
March 2010
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January 2010
December 2009
The study found that those who were prescribed addictive medications were 9.5 times more likely
to engage in this behavior than those who received non-addictive medication. The prescription
drugs most associated with doctor shopping were benzodiazepines (4.2 percent) and opioids
(12.8 percent).
2. Patient-related factors, illness variables – Dependence is not the sole reason that patients
doctor-shop. Studies determined that we might attribute this to the patient seeing no improvement
in the illness and/or having a lack of understanding of either the offered diagnosis or the
treatment.
3. Physician-related factors – Despite many of the articles focusing on the patient factors that go
into the development of this issue, a number of studies examined specific physician factors. Some
of the factors that may contribute to a patient’s likelihood in seeking out other physicians included
extended waiting times and physician attitude (if the physician was particularly strict, stern or
stringent). Other physician factors included insufficient time for communication between the
physician and the patient, undesirable personal qualities of the physician and inconvenient office
hours or locations.
What Can We Do to Stop this?
Numerous states are using drug-monitoring programs in order to make it harder for patients
to visit a number of different physicians. Studies already show that we can decrease the
prevalence of doctor shopping by introducing these statewide monitoring programs.
However, many regulators are calling for a nation-wide program instead of just having a
state-by-state program. Depending on the location, a federal program would be highly
beneficial.
For example, someone in California may drive six hours and still be in the same state.
Meanwhile, someone in the New England area can hit several different states within the
same amount of time. This would render the entire statewide program useless unless clinics
decided to fill prescriptions for state residents exclusively.
Many physicians also readily admit that while in medical school, they receive no real
education about addiction. While it is true that physicians need to keep a watchful eye and
not simply give patients anything they want, we also have to understand that these are not
trained DEA agents.
These physicians have to straddle the fine line between wanting to help someone who
comes into their office and actively helping them foster dependence. They also do not want
to alienate current patients or stigmatize people who use commonly abused medications for
genuine medical problems.
Tackling the Issue at the Root
Because doctor shopping is a relatively complex phenomenon and we are still a long way off
from a federal database, treating the problem at the core may be the only way to treat the
issue at this point. Whereas someone doctor shopping for monetary gain may continue to do
so until they are prevented from doing so, patients struggling with addiction can get help to
live a sober lifestyle. If you know someone or you yourself are struggling with dependence on
prescription medication, make sure that you seek out professional drug recovery treatment
as soon as possible.
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Posted by Drug Rehab Counselor | in Uncategorized | 1 Comment »
One Comment on “Doctor Shopping – Big Problem for Police and Doctors”
1. Gladys Lipinski Says:
January 22nd, 2014 at 12:57 am
This mentions a good solution – having a federal database. Sounds doable if the federal
govts have the political will. More often than not, they don’t Yes, that’s sad but true. This
could take a long time coming, huh?
But we need solutions NOW. What could be done among families could help right away. Like
if there’s someone in the family prescribed with a drug, then it must be closely monitored. It
pays to be careful, especially because any drug can be abused and addictive. Why not put
extra effort at ensuring this doesn’t happen right in one’s own home?
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