According to the Drug Enforcement Administration (DEA), “doctor shopping” and frequent early refill request are one of the primary ways that addicts obtain prescription drugs for non-medical use. “Doctor shopping” refers to when an individual visits several different doctors to obtain prescriptions for the same medications, and then has the prescriptions filled at different pharmacies. This allows the individual to obtain more of the prescribed substance than any one physician or pharmacist would allow. Legally, doctor shopping is not a minor matter; it is prosecuted as a felony and is punishable by up to five years in prison.
At a 2006 hearing, a high-ranking official from the DEA testified before the House Government Reform Committee Subcommittee on Criminal Justice, Drug Policy, and Human Resources regarding current efforts to address prescription drug abuse in the United States. According to Mr. Rannazzisi’s testimony, doctor shopping is a growing problem in this country and is a primary means for addicts to obtain prescription medication for illicit use. Mr. Rannazzisi referred to prescription drug abuse as an “epidemic.”
Other illegal activities associated with doctor shopping may include the forgery of prescriptions or the sale or transfer of the drug to others. To address this situation, PDMPs (prescription drug monitoring programs) are being introduced in many states. These programs are designed to allow physicians and pharmacists to cross-check prescriptions with each other and identify individuals who may be doctor shopping.
Abuse of prescribed medicines often begins with legitimate use. Because of this, individuals who otherwise would not abuse substances find themselves addicted when it is already too late. They begin doctor shopping to feed their addiction, but rationalize this behavior as being necessary to manage the pain and maintain the façade of being in control. Pain medication, prescribed for a variety of common reasons, including back pain or surgery, caesarian sections, or even dental procedures, carries the highest risk for dependence.
One Ohio mom recently posted her story on a public message board. She related having had three back surgeries and a herniated disk in her neck. She started on pain medication after her daughter was born by C-section. Soon, the medication from her pain management physician wasn’t enough. She went to see another physician, and then another.
She was finally caught when a doctor’s office, where she had called to schedule an appointment, asked for her social security number. Apparently, the office participated in a PDMP and had access to a list of all the physicians and pharmacies she had used. The office contacted her husband and provided him with a copy of the list. Now she is enrolled in a treatment program.
This story is typical of many pain medication abusers - middle- and upper-class individuals who lead otherwise respectable lives.
In 2006, one of the most famous doctor shopping and prescription drug abuse stories came to light. Conservative talk show host Rush Limbaugh turned himself in to Palm Beach authorities for doctor shopping. From 1998 to 2006, Limbaugh obtained massive amounts of the painkiller OxyContin, both through multiple prescriptions from different health care providers and through illegal channels. Limbaugh began taking painkillers in the late 1990s after an unsuccessful back surgery. By the time he turned himself in to police, he was rumored to be taking up to 30 pills per day. His drug abuse was severe enough to damage his hearing. According to a 2004 statement from the White House’s Drug Czar John Walter, “The non-medical use of prescription drugs has become an increasingly widespread and serious problem in this country; one that calls for immediate action. The Federal government is embarking on a comprehensive effort to ensure that potentially addictive medications are dispensed and used safely and effectively.”
A study completed by the Boston University School of Medicine in 2006 reported that more than 10 million Americans are taking opioid medications to treat pain, and more than 40% of those use potent painkillers on a regular basis. The study consisted of random telephone surveys of 19,000 adults from 1998 through 2006. With such a jump in use and abuse of pain medication by Americans, it’s no surprise that associated behaviors such as doctor shopping and prescription fraud are also on the rise.