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Substance Abuse and Addiction Health Center

Doctor-Shopping for Painkillers Common After This

1 in 5 patients sought narcotics from multiple physicians
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Overall, 21 percent of the patients tried to get narcotic painkillers from more than just the surgeon who treated them. Patients who weren't college-educated were 3.2 times more likely to try to get the drugs from more than one doctor, and those who had used narcotic painkillers before were 4.5 times more likely.

The doctor shoppers -- who were mostly white males -- used narcotics for about 3.5 months after surgery whereas single-provider painkiller users took them for four weeks on average, the study found. Many obtained seven or more narcotic prescriptions compared to two prescriptions for single-provider patients.

Whether the doctor shoppers had legitimate pain needs isn't clear from the study. "The ER is definitely an area where people doctor-shop. But I don't know that they're going to be having an orthopedic trauma to get drugs," said Worley.

It's possible, she said, that some of the patients went to other doctors, perhaps their own physicians, in search of painkillers.

Whatever the reasons, Morris and Worley called for more reliable systems to prevent patients from abusing narcotic painkillers.

Worley said physicians should be wary of patients who pay with cash since doctor-shoppers with insurance are more easily detected. It's also helpful to check patients for needle marks and to use more extensive drug test procedures to make sure patients aren't sneaking in someone else's urine, she said.

Morris added that one important way to help identify patients who are doctor-shopping is by using a prescription drug-monitoring program. Nearly all states have an active prescription drug-monitoring program, "but only seven states actually mandate use of these programs," he said.

"Physicians and patients have to work together," he added, "to establish reasonable expectations for pain control and to identify at-risk patients early on to allow appropriate interventions."

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