State aims to curb ‘doctor shopping’ and prescription drug abuse
November 28, 2014
Colorado officials are aiming to curb prescription drug abuse by notifying subscribers who might be a target for "doctor shopping."
The Colorado Department of Regulatory Agencies sent out 600 notifications in late October to providers and prescribers across the state that may have prescribed controlled substances to people who also had sought the same prescription elsewhere.
Practitioners receiving the notifications were asked to use clinical judgment to determine the appropriate response.
Lyons Drug Store Doctor of Pharmacy Matt Johnson said he wasn't surprised when the pharmacy received a notification.
"Frankly, this is old news. Doctor shopping has been around for decades," said Johnson, who has been a technician since 1996 and a doctor of pharmacy since 2007.
Johnson said he hasn't gauged an uptick in the problem in recent years, only in the public's awareness of prescription drug abuse.
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Providers and pharmacies are logged into the Colorado Prescription Drug Monitoring Program database, which allows them to search for a patient to see whether that patient recently has had similar prescriptions filled elsewhere before filling a new prescription.
"It can tell you where they've been," Johnson said. "It's helpful, but it has its holes — it's not always 100 percent accurate."
The database is useful to spot some abusers and allows pharmacies to help doctors, who may not have the means to find out if a patient is visiting another doctor simultaneously.
Johnson said that if he initially looks up a prescription and finds it recently was filled elsewhere, he might give the customer a friendly reminder that it isn't due to be filled yet but hang on to the prescription.
He also might call other pharmacies to make them aware of the doctor shopping.
Repeat abusers often identify the doctors more likely to write prescriptions, according to Dennis Martinez, chief probation officer with the 14th Judicial District, which serves Moffat, Routt and Grand counties.
"Our offenders do some doctor shopping," Martinez said. "They have very good communication skills in regards to finding sources. Our defendants seem to have no problem getting 90 pills of Xanax at once."
Martinez said that part of the responsibility for dealing with prescription drug abuse falls on law enforcement and the medical community.
"I think it's all of our responsibility," he said.
Some doctors and pharmacies are better at checking the PDMD database than others, Martinez said.
"I've often found that doctors don't check that list," he said.
Martinez said he wouldn't place too much blame on doctors, though, as their job is to identify a patient's need and prescribe something accordingly.
He said those in the drug court program are asked to declare themselves as addicts and limit their contact to one physician and one pharmacy when obtaining controlled substances for legitimate uses.
Johnson said that pharmacies try to handle repeat abusers with the same approach, keeping them with one doctor and one pharmacy, if possible.
"Then it gets everyone on the same page," Johnson said. "The gold standard is to get them wrangled into one doctor and one pharmacy — it's better for them, and it's better for us."
Tearing up a prescription for someone who is doctor shopping or trying to get other pharmacies to do the same won't solve the problem of drug abuse, so it isn't a tactic Johnson suggests, he said.
"Doctor shopping is not illegal," he said. "People who are doctor shopping have a problem."