Should 'Doctor Shopping' be a crime?

Published on July 12, 2005 By dharmagrl In Current Events

Just when we thought Rush Limbaugh and his addiction to prescription drugs were old news, we're informed that he could be facing criminal charges for 'doctor shopping'.

For those who don't know, 'doctor shopping' is a term used to describe drug seeking activity by patients with either a dependency on or a taste for prescription narcotics. Patients will go to a variety of different physicans, sometimes with a real ailment that they milk for all it's worth or an exaggerated/false illness, and they'll ask for a prescription for pain medications. Usually none of the physicans are aware that they're not the only one treating the patient, and if they do know about their shared care they're not usually aware that multiple prescriptions for narcotics are being written.

People who enagage in this activity will fill their prescriptions at different pharmacies, pay cash for their medications rather than file an insurance claim, and sometimes will use an assumed name in an effort to avoid detection.

At the moment, only one state in the nation (Florida) has laws against doctor shopping.

So, should this behaviour and activity be a crime?

Tell me what you think...

Comments (Page 1)

Dr Guy

on Jul 12, 2005

About the Limbaugh non-charge? Or the crime on the books?

The former, it will never be brought to trial. The latter, it is unproveable.

Like Passing a law against sodomy between husband and wife. You really want anyone looking into your bedroom to see if you are obeying that kind of law?

just john

on Jul 12, 2005

This is a tough one. It is an abuse of the system but one the system hasn't put any stops in for. Even if it was illegal, I think it would be difficult to catch these people. I do think it is wrong. These meds could be ending up on the street and in the hands of young ones who think drinking with pain pills is fun and not so dangerous. Still it's going to be a tough thing to enforce unless there is some sort of major drug store or physician cooperation.

Moderateman

on Jul 12, 2005

yep if there is a law on the books that prohibit "dr. shopping" then rush must face the music.

BUT, using someones medical records for a fishing expedation is low and dangerous to ALL of us.

Do you want anyone in law to have free and clear access to your medical files?

I know I do not.

Reiki-House

on Jul 12, 2005

This is an odd question you pose. The term 'doctor shopping' can be turned into a term which suggests a bit of innocent wrongdoing perhaps not worthy enough to be labelled a crime. I don't know most people's personal politics, but I can only assume this is in reference to Rush Limbauch's duplicit use of narcotics which we all know, from common sense and from any responsible pharmacist who fills our prescription, limits our mental capacity while under the influence. The large quantities of pills listed in his indictment certainly suggest constant use by a chronic drug addict, and by that I mean at any given time he would give a piss test he would be found to have narcotic sedatives in his system. Overall I think it's more sad than anything. The poor guy made some now-disastrous comments about drug using democrats and he was made to publicly defend hiself about doctor-client priveledges and the right to privacy, but we all know he didn't have any problems with due-diligence in any investigations or so-called 'liberals'. I never feel animosity towards Rush and his addiction. I feel animosity for his having slandered other addicts when he was flying high (literally) as a moral Republican non-drug-addicted personality. One HAS to talk the talk if they take a public stand over a particular position. A good example was Bob Barr's comments about how Clinton makes a mockery of family and marriage and family values and christian living, meanwhile not thinking the public would be bombarded with facts of his real respect for marriage. He held marriage as such a moral responsibility he embarked on his moral crusade three times. He even left one cancer-diagnosed moral responsibility for another healthier and younger moral responsibility. When you can't hold others to the same standards you demand, you have no right to talk about morality at all, whatsoever.
Dharm doctor shopping is wrong as well as illegal. You want to become the biggest most successful drug addict enabler in the world? Get rid of controls which forbid and trace people who try take more pills than they obviously need. Maybe your kids will be unlucky enough to come across even one of the thousands of pills which are in addict's hands because they doctor shop for their pills. While I don't crass out anyone who wishes to use drugs for entertaining feelgood fun, I DO crass out over thousands of illegally gotten pills which could do harm to others. Put it this way. Once someone is in possession of more drugs than he could hope to take himself in a month, the risk of harm increases.

bakerstreet

on Jul 12, 2005

No, it shouldn't. If doctors hand out prescriptions to people who don't need them, then they should be charged. If people take their prescription medicine and sell it on the street, they should be charged. To go any deeper requires the government to scrutinize our medical conditions, and decide if we really needed to change doctors or not, or if we really needed those pills or not.

In short, it's just another way for nasty local prosecutors to stick it to people they want to.

ParaTed2k

on Jul 12, 2005

Wow, I'm sitting here nodding my head in agreement with Reiki House. Mark this day on your calendars folks it won't happen often!!

Where did we get so paranoid in our "war on drugs" that we decided that legitimate control of pain is a legal, instead of medical decision? I can understand wanting to keep a lid on recreational use of drugs, but if a physician can justify prescribing pain medication to a patient who suffers chronic pain, what is the problem?

From what I've read and heard, Rush Limbaugh has a lot of back problems. He has been through all the standard surgeries to correct the problem, but none of them did much more than reduce the pain. So he was prescribed pain medication up until the time he reached some magicaly, bureacratic time limit when (I guess by magic) all pain apparently subsides and patients no longer have a need for the medication. "Doctor Shopping" wouldn't even be an issue to legislate if the DEA would get off of the backs of Doctors and let them practice medicine.

On the other hand (and this is where I agree with Reiki House), Rush has always been really harsh on any drug addict. Most of us who have been listening to him for long enough remember his total thrashing of Kirk Cobaine after he committed suicide. Apparently both had a chronic pain problem, they just turned to different drugs to control it. Who knows, if Kirk Cobaine could have legally consulted a doctor for his medical problems, he would have had better advice than the illegal meds he turned to (of course, that would be assuming he'd take the doctor's advice and stay away from the illegal drugs while on the legal ones). Of course, then we'd never have the "Foo Fighters" which to me are tons better than Nivana anyway (although I did like Nirvana).

Yes, Rush might just have to face the courts. However, if he was legitimately in pain, why should he ever have had to turn to illegal actions for which he's been accused?

dharmagrl

on Jul 12, 2005

The latter, it is unproveable.

Actually, it's proveable. You don't even have to dig into a person's medical records to do it. Physicians have to keep very accurate records of the narcotics they prescribe and whom they prescribe them to....

Still it's going to be a tough thing to enforce unless there is some sort of major drug store or physician cooperation.

Good point.

Do you want anyone in law to have free and clear access to your medical files?

Nope. Doctor patient confidentiality...

if a physician can justify prescribing pain medication to a patient who suffers chronic pain, what is the problem?

The point that youy're missing is that people who doctor shop will also fabricate a condition to get meds for it. You're looking at this from the POV that thos who doctor shop have chronic pain, and that's not the case.

Who knows, if Kirk Cobaine could have legally consulted a doctor for his medical problems, he would have had better advice than the illegal meds he turned to (of course, that would be assuming he'd take the doctor's advice and stay away from the illegal drugs while on the legal ones).

It's Kurt, and he DID consult a physician. He simply found that smack worked better for him than anything the doctor gave him, and because of his history with dependence on street drugs a lot of physicians woudn't prescribe him narcotics.

Trudygolightly

on Jul 12, 2005

I think that abuse of medicine has a chance of being stymied by the use of computers now. For example, I can go to
my doctor and get an Rx, BUT, any Rx's this doctor and any doctor that's taken care of me, (in my health care system) has a record of my getting said Rx's. Hopefully this might help stop the abuse you're talking about. To answer your question though,
do I think it should be a crime?
I think it is illegal to 'doctor shop", in so far as getting too many narcotics for pain within a certain time frame, just like it's illegal
to give a Rx of yours to a friend or relative, or worse to sell it! it isn't illegal to
go from doctor to doctor, but it seems like it is illegal to get ahold of too many narcotics at one time.
I have a relative
that was hooked on Tylenol 3 and wanted me to get my Rx filled to give her. I didn't know it was illegal to give someone a couple of pills that one has, and then I saw on tv that Winona Ryder got in trouble for that! So I told my relative that while I didn't think
it hurt to give her something I already had, that I had just discovered that what she was asking me to do was illegal and I
wanted no part of that!
If people try to make it illegal to go from one doctor to another, there'll be outcries of our rights being violated and all ---- will break
out! Nuf Said!

Myrrander

on Jul 12, 2005

Actually, toward the end of his life, Cobain had begun taking a non-opiate medicine that helped his stomach condition. It's in his journals, I'll look up the name when I have time. It is this that makes people speculate that the 3 times lethal dose found in his system after his "suicide" really means that he was forcibly drugged and then murdered for his money.

The only reason I'm against doctor shopping is that if each precription is claimed on the person insurance, that's driving up costs for all of us. If the person pays for this stuff themselves, let them have the pills they want.

Drug laws in this country are insane. Drugs should be legal. Even smack.

Cheers.

dharmagrl

on Jul 12, 2005

so far as getting too many narcotics for pain within a certain time frame,

Exactly. You go beyond 'for medicinal purposes' and get into 'for recreational use' territory.
Myrr: I'm with you on the insurance issue. If a person is paying for it themselves, then fair enough, but my worry is more with the physicians who end up getting reprimanded for being too loose and free with the narcotics.
I know that he was taking a non-opiate, and I think it was tramadol? Aka Ultram. I don't have a copy of his journal....but you've promted me to go get one. Thanks!

dharmagrl

on Jul 12, 2005

Reiki, I gave you an insightful for that comment. Truly well written. And, I agree!

bakerstreet

on Jul 12, 2005

I've never been able to pin down what kind of abdominal illness Cobain had, but if it is anything like the one I have doctors won't give you pain medication for it. They certainly won't give me any, because anything "feel good" is horribly addictive if you suffer from a disease that makes you "feel bad" all the time. Stimulants OR depressants aren't negotiable according to my doctor, since there's not really any cure and anything I take I'd just have to keep taking from now on.

ParaTed2k

on Jul 12, 2005

Not missing the point in general, just talking about situations like Rush Limbaugh's (and apparently Bakerstreet's). There are a lot of ways to keep accountability of meds prescribed without resorting to telling a patient with chronic pain that they have no legal recourse.

When your crime is experiencing pain 1 day longer than some know-nothing sitting comfortably in an air conditioned office has deemed "appropriate, the only real criminal is the idiot in the office.

...and yes, it was "Kurt".

dharmagrl

on Jul 12, 2005

They certainly won't give me any, because anything "feel good" is horribly addictive if you suffer from a disease that makes you "feel bad" all the time

Which is part of the reason I pushed hard to get my back surgically fixed and why I'm so happy that it's getting fixed. I can't be on narcotics forever...I don't WANT to be on narcotics forever, and if I'm on them for much longer I'm afraid I'll end up with a physical dependency. So, surgery's the best way to go.

just talking about situations like Rush Limbaugh's (and apparently Bakerstreet's). There are a lot of ways to keep accountability of meds prescribed without resorting to telling a patient with chronic pain that they have no legal recourse.

Yes, but a lot of those rely on the patient being honest. If a pt ends up with a 'taste' for them and decides to go doctor shopping....well, it would be easy to lie to get your stash, you dig?

drmiler

on Jul 12, 2005

if a physician can justify prescribing pain medication to a patient who suffers chronic pain, what is the problem?

The point that youy're missing is that people who doctor shop will also fabricate a condition to get meds for it.

The point that you seem to be missing is the FACT that he has a DOCUMENTED factual history of "chronic" back pain. And has as such ALL associated surguries that might have helped him. Which none did.

The latter, it is unproveable.

Actually, it's proveable. You don't even have to dig into a person's medical records to do it. Physicians have to keep very accurate records of the narcotics they prescribe and whom they prescribe them to....

And if this was so "provable" then why did they bitch, whine, complain and push to get his "medical records"? And just for your edification, the records of narcotics perscribed that you speak of are PART of the patients records! And as such you NEED to "dig" into a patients med history.

What I'd really like to know is what do you have against Rush that you're screaming for his blood?

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