Doctor Shopping And The Opioid Epidemic

Medically Reviewed by Johnelle Smith, M.D. on July 14, 2021

With the increased use of telemedicine appointments during the pandemic, doctor shopping has become more of an issue in some areas across the United States. This kind of drug diversion can easily lead to drug addiction.

Doctor Shopping During The Opioid Epidemic

Doctor shopping is defined as seeking multiple treatment providers, either during an illness episode or to obtain prescription medications illegally.

People who are prescribed prescription opioids and develop an addiction to these medications may doctor shop to ensure their supply.

This is becoming a contributing factor to the opioid epidemic.

Drugs commonly sought while doctor shopping include:

  • prescription pain medications (opioids/opiates)
  • painkillers such as oxycodone, oxycontin, hydrocodone, and Vicodin
  • benzodiazepines such as Xanax
  • methadone

Prescription drug abuse, and lying to obtain multiple prescriptions for controlled substances, is considered prescription fraud and is illegal both federally and at the state level.

How Often Do People Doctor Shop?

Rates of doctor shopping vary from state to state within the United States.

Due to the prescribing law differences in each state, the rate of doctor shopping in the U.S. ranges from a little more than six percent up to 53 percent.

This significant difference is also in part due to the different definitions of doctor shopping.

Healthcare providers do what they can to help each patient but, in some cases, a prescription may not be given.

Common Reasons For Doctor Shopping

There are many reasons someone may choose to participate in doctor shopping.

Often, opioids are prescribed as a pain management technique for legitimate medical concerns. However, once the prescription is out and the injury is healed, opioid use disorder can develop.

A few reasons doctor shoppers commonly give to explain their behavior include:

  • inconvenient office hours/location
  • long wait times (in-office)
  • disliking the healthcare practitioner’s personality
  • insufficient communication between the patient and clinician
  • persistent symptoms
  • nonacceptance of the diagnosis
  • seeking prescription drugs for recreational use

Doctor Shopping Within Families

One study from the University of Michigan looked at more than 554,000 privately insured individuals and any relatives also covered under the same plan.

This study specifically looked at individuals who had received opioid prescriptions from four or more prescribers and filled them at four or more pharmacies over the past year.

Based on prescription history, it was determined that 210 million opioid prescriptions in 2016 may have been dispensed to people who have a family member with doctor shopping behaviors.

How Is Doctor Shopping Worsening The Opioid Epidemic?

Doctor shopping increases the number of opioid medications accessible for abuse and illegal use.

This, in turn, worsens the opioid epidemic because it increases the likelihood that someone without a prescription will have access to and freely abuse the substance.

What Is Being Done To Stop Doctor Shopping?

Some measures are being taken to prevent doctor shopping, including:

  • healthcare professionals reviewing insurance records
  • prescription drug monitoring programs (in every state except Missouri)
  • increased opioid prescribing education for law enforcement

Up to 39 of the 50 states now expressly state situations when physicians, physician assistants, and nurse practitioners must check their state’s prescribing databases before prescribing opioids or other controlled substances.

Doctor Shopping Laws In The United States

Over the last decade, each state has also introduced its own doctor shopping laws, starting with the uniform controlled substances act of 1970.

States with general doctor shopping laws prohibit the patient from getting drugs through any of the following means:

  • fraud
  • deceit
  • misrepresentation
  • subterfuge
  • concealment of a material fact

Drug laws vary, depending on the state. Some states have put in place general doctor shopping laws, while others have instituted more specific drug laws.

Examples Of Drug Laws By State

The drug laws in California, for example, contain language from the Uniform Narcotic Drug Act that states no person shall obtain controlled substances, or administer them illegally.

On the other hand, states like Kentucky have general drug laws which simply state that knowingly obtaining controlled substances is illegal.

Do Prescription Drug Monitoring Programs (PDMPs) Help?

Prescription Drug Monitoring Programs collect data about controlled substances such as opioids from in-state pharmacists and mail-order pharmacies that ship prescriptions.

Prescription opioid abuse is a serious issue in the U.S., but help is available.

While PDMPs are a step in the right direction, there are still many privacy laws such as HIPAA that prevent providers from checking these databases to look for “shopping” behaviors.

Some physicians disagree with PDMPs because they don’t necessarily take the individual’s mental health into account.

Finding The Best Prescription Drug Treatment For Your Situation

If you or a loved one have experienced doctor shopping due to uncontrolled drug use, it may be time to seek help.

Contact our substance abuse treatment helpline today for a free addiction assessment and professional advice on finding an addiction treatment program that works for your situation.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D. on July 14, 2021
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