The term “doctor shopper” refers to the prescription drug addicts who are so intent on getting more of their pills of choice that they go to multiple doctors in order to get multiple prescriptions for the same or similar drugs. A sign of addiction, this is an illegal act and one that legislators and the medical community have attempted to circumvent by implementing statewide drug databases. These databases can be accessed by prescribing physicians and pharmacists, enabling them to see what prescriptions are currently active and being filled for the patient, thus identifying the patients who are receiving multiple addictive prescriptions.
Though these databases have been somewhat effective, a new study published in the journal Pharmacoepidemiology and Drug Safety found that about one-third of “doctor shoppers” have no problem crossing state lines in order to get more of their drug of choice. They will go to multiple doctors looking for one who will give them the prescription they’re looking for – thus making the databases that are limited to one state ineffective.
Researchers also found that:
- Prescription drug-seeking patients see an average of 10 doctors each year.
- Each doctor-shopping patient received an average of 32 prescriptions annually.
- Cash payments were commonly used to avoid getting caught.
- An estimated 1 percent of buyers of addictive prescription drugs were doctor shoppers in 2008.
Douglas McDonald of Abt Associates is co-author of the study. He said: “Part of the problem is that state systems all vary – they’re either home-grown or operated by different vendors and they’re not interoperable. There are also legal questions about what you can share about patient data.”
Continued Efforts to Stem Prescription Drug Abuse
State officials are well aware of this practice and making efforts to work together with bordering states in order to combat the problem of border-crossing doctor shoppers, according to The Washington Post. For example, Delaware, New York, and New Jersey have all agreed to share prescription information across state lines, as have the New England states.
Some officials believe that interstate sharing of data for bordering states is not enough; they believe that a nationwide prescription database is necessary.
Ultimately, the goal is not only to curb the illegal activity but also to:
- Identify patients struggling with addiction
- Connect those patients with addiction treatment services
- Decrease the risk of overdose among patients
- Decrease the diversion of prescription medications
The Role of Prescribing Physicians
State officials aren’t the only ones taking measures to decrease the rates of prescription drug abuse, addiction, and overdose among patients. The doctors who write the prescriptions, too, are taking precautions as well.
According to a report published in the journal JAMA Internal Medicine, about half of all primary care doctors say that they are not as likely to prescribe addictive medications today as compared to last year. An estimated 90 percent of responding physicians said that they were worried about the rate of prescription drug misuse in their cities.
Additionally, the report found that:
- About 85 percent of physicians say that physicians overprescribe addictive painkillers.
- About 50 percent said that they believe that high rates of addiction, car accidents, and sudden death were related to the overuse or misuse of painkillers.
- About 56 percent of responding doctors said they believe that physical dependence upon narcotic medications occurred even if the drugs were taken exactly as prescribed.
- An estimated 62 percent of responding physicians said that tolerance often developed among patients prescribed these medications even if they took them as directed.
Dr. G. Caleb Alexander of the Johns Hopkins Bloomberg School of Public Health is leader of the study. In a news release he said: “Our findings suggest that primary care providers have become aware of the scope of the prescription opioid crisis and are responding in ways that are important, including reducing their over-reliance on these medicines. The health care community has long been part of the problem, and now they appear to be part of the solution to this complex epidemic.”
Holistic Pain Management
In addition to increasing drug monitoring and decreasing the number of prescriptions, another way to limit the rates of prescription drug abuse is to help patients take advantage of holistic treatment options that are safe to manage their pain. Some options include:
- Massage. Regular massage can serve to decrease cramping and muscle pain. Massage therapists may be able to provide focused attention to injured areas.
- Acupuncture. Long thin needles are inserted into the top layers of the skin painlessly at points determined by the area of the injury.
- Acupressure. Rather than long needles, pressure is placed on points of the body that correspond to the areas of body where there is pain.
- Physical therapy. A physical therapist can prescribe exercises and work individually with the patient regularly to help them strengthen their muscles and decrease pain.
In some cases, gentle exercise like swimming and walking can serve to strengthen muscles and improve sleep, which in turn can decrease the experience of pain. In combination with each other, these options may be even more effective than just one alone. Some find that even if holistic treatments are not enough to manage or mitigate pain alone, they augment medication therapy and allow for lower doses of addictive and potentially dangerous drugs. Any efforts to decrease the use of these medications can serve to cut the rate of newly addicted patients and overdose as well.