Medical Forum / General / Pharmacy / May 2006
Doctor Shopping/Diversion....
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Mahheyta - 07 May 2006 17:37 GMT In the state I live in, doctor shopping is a form of diversion and is considered a crime. For those of you who don't know what that is (and I'm sure most do) it's going to multiple doctors for the same controlled substance without the knowledge of the doctors. For instance, you could be seeing Dr. Jones for back pain and he is prescribing 10mg Lortabs and also be seeing Dr. Smith for the same thing who is prescribing Vicodin ES. That is illegal here and is actually considered a class D felony. People have been prosecuted and sent to prison for this, it's considered no different than forging a script. I'm wondering if it's the same in every state.
I have a friend who calls it "tweaking the system," but I disgree. This type of behavior should be prosecuted in my opinion. Here, we have a prescription monitoring service that keeps track of doctors, pharmacists and patients by keeping track of all controlled substances that are prescribed, filled and purchased, how many states have this? Would it be possible to have a federal system?
I read about a guy locally (some dunderheaded jackass) who was seeing 10 different doctors for the same things, interestingly, it took the computer that is responsible for keeping track of diversion 10 months to catch up with him!
Pumbaa - 08 May 2006 18:09 GMT > In the state I live in, doctor shopping is a form of diversion and is > considered a crime. For those of you who don't know what that is (and [quoted text clipped - 18 lines] > computer that is responsible for keeping track of diversion 10 months > to catch up with him! It should be easy to catch Doctor Shopping by anyone who is using either private insurance, Medicade or Medicare. If office visits and pharmacy visits are paid with cash then it will be a problem. If we had a federal system then we would have to have some sort of federal medical account number. I don't think most Americans really like the idea of one ID number to access your whole life style. The Social Security number of a person causes enought problems when it is used by a person that it is not issued to. Prohibition did not work for booze and it certainly does not work for drugs. It does make for a lot of criminals and crooked police officers.
Paul Trusten, R.Ph. - 13 May 2006 22:01 GMT I was told by a New Zealander friend of mine that all New Zealand pharmacies are online with each other, without regard to insurance plans. So, for example, a prescription filled in Auckland would be cross-referenced with an actual or therapeutic duplicate in Christchurch.
> > In the state I live in, doctor shopping is a form of diversion and is > > considered a crime. For those of you who don't know what that is (and [quoted text clipped - 28 lines] > to. Prohibition did not work for booze and it certainly does not work for > drugs. It does make for a lot of criminals and crooked police officers. Mahheyta - 14 May 2006 03:29 GMT Interesting, That's the type of system I was referring to in my initial post. Assuming your friend means that ALL pharmacies are connected with each other, not just pharmacies who share the same name. For instance, here in the states, all Walgreens are connected but for states without their own individual prescription monitoring service, that does nothing to stem diversion because their are hundreds of different stores that don't share information.
Pumbaa - 14 May 2006 15:53 GMT > Interesting, That's the type of system I was referring to in my initial > post. Assuming your friend means that ALL pharmacies are connected [quoted text clipped - 3 lines] > that does nothing to stem diversion because their are hundreds of > different stores that don't share information. One thing is certain if you are a doctor shopper then you had better support your local independent drug stores. They are not going to have access to chain pharmacies customer databases until they are forced by some government agency. In my small town, so far, Wally World is the only chain outfit with a pharmacy that I am blessed with. I don't use them myself, but two independent pharmacies in my town have closed since Mao Mark opened.
Mahheyta - 14 May 2006 21:06 GMT Here in Kentucky, they have a system called KASPER that keeps track of these things and even the mom and pop pharmacies are required to report any controlled substance that is filled to the state, be it Valium or OxyContin. Other states have follwed suit, I know Indiana, Texas, Illinois and a few other states have similar systems. Again, if you play by the rules you shouldn't have any problems, that should be obvious (not directing this at you at all but there are some people who are extremely paranoid).
karl1973@my-deja.com - 09 May 2006 22:24 GMT I view trying to track people as a gigantic waste of time, effort, and resources. If some junkie wants drugs, they'll get them one way or another. Everyone else gets treating like a criminal all to catch those relatively few who do this.
And while we're arresting a guy who got too much Valium, for example, other folks are buying unlimited amounts of booze at the liquor store.
Which do you think is more dangerous: unlimited amounts of 190-proof Everclear from the liquor store or unlimited amounts of Valium from ten doctors? It strike me that the Everclear is vastly more likely to result in death by OD and in the long run heavy drinking will destroy your liver, a problem you won't have with Valium.
Prohibition didn't work 80 years ago. The DEA has been around 35 years trying to win the drug war with no end in sight. When will our politicians figure out drug prohibition doesn't work. Never has, never will.
Mahheyta - 10 May 2006 02:45 GMT > I view trying to track people as a gigantic waste of time, effort, and > resources. If some junkie wants drugs, they'll get them one way or [quoted text clipped - 14 lines] > politicians figure out drug prohibition doesn't work. Never has, never > will. You know, I'm on Klonopin, Vicodin and Ambien (albiet not all of them on a regular basis) and I live in the most rigid state in the country and I've never encountered a problem. You won't, if you play by the rules, why would you?
Remember, there wouldn't even be a system in place if not for the crooked doctors who run pill mills and their patients who either wolf down 200mg's of Oxy a day or sell their scripts to pay the rent. When OxyContin became available it wasn't long before if became a major problem here, pharmacies were getting robbed, doctors were running illegal pill mills and people were seeing multiple doctors to get the same type of medication (be it Oxy or Hydrocodone). Something had to be done, it was and it has been relatively successful and will continue to improve. Even surrounding states joined in to prevent people from border hopping to see different docs.
The same system also keeps track of the products that are sold in drug stores used to make meth. Since these cold medicines were put behind the counter and people had to sign them out, meth lab seizures have gone down 70 percent. And it doesn't work? BS.
As far as booze is concerned, I don't drink but I agree that alcohol is more dangerous than many drugs, inluding marijuana. As long as there are parking lots at bars people will be driving drunk, a whole other issue there. Bottom line, I completely disagree that it's a "waste of time" to track illegal pill poppers, quacks and crooked pharmacists.
karl1973@my-deja.com - 10 May 2006 09:24 GMT You talk about the Oxy problem. It was in large part a creation of the media. The evening news tells everyone that Oxy is "Hillbilly Heroin". Before it made the news few people outside the medical community and pain patients had ever heard of this drug. And then the next day a pharmacy is robbed at gunpoint and they ask for OxyContin by name. Golly, I wonder where the junkies ever got this idea? It's almost as if they'd seen it on TV. After making OxyContin a household name and effectively telling the junkies what to ask for when they rob pharmacies, then the media reports on the pharmacy robberies that they played a clear role in. They actually helped to make the news they are reporting.
And one of the reasons junkies turned to Oxy was because the DEA was squeezing their heroin supply. Can't get heroin, so switch to prescription drugs.
Capitalism is the most powerful force known to man. As long as somebody is willing to pay for drugs, there will be a supply. The only thing the DEA and other law enforcement can do is cut down on supply. That raises prices and creates additional crime. If a junkie steals your car or robs you at gunpoint to pay for their expensive drug habit (a habit that is only expensive due to prohibition) will you send the DEA a thank you note telling them how safe they make you feel?
Milton Friedman estimated that drug prohibition results in 10,000 additional homicides each year in the US. Do you wish to disagree with a Nobel Laureate? Every war results in death and the War On Drugs is no different.
Pumbaa - 10 May 2006 15:07 GMT <Snip>
> Milton Friedman estimated that drug prohibition results in 10,000 > additional homicides each year in the US. Do you wish to disagree with > a Nobel Laureate? Every war results in death and the War On Drugs is > no different. Just how bad was the drug problem in the US before the Harrison Narcotic Act was passed? At one time a person could just walk into a pharmacy and buy morphine or codeine. There was Tincture of Opium, Paregoric, Cocaine (even in Coca-Cola)TM etc. I remember in the State of MS when I could buy Paregoric without a Rx. Sometimes the cops would find a junkie in a local motel filtering it and removing the alcohol and shooting it IV.
However they were NOT! shooting people over it, robbing people, etc., and the cops were not getting paid to look the other way. If grandma wanted her Tincture of Opium she could just go to the drug store and buy it. Sure some people were addicted to drugs way back then but today they are addicted to drugs and called criminals.
Some places like Washington DC have tried firearm prohibition. It is now illegal to own a handgun in DC. Yet DC has one of the highest, if not the highest, murder rates in the entire US. The government never learns from history.
Mahheyta - 12 May 2006 22:09 GMT Well, first of all, trying to compare todays society with the 1800's and early 1900's doesn't make any sense. Legalizing all scheduled drugs in todays society would be an absolute train wreck. The poor sod busters who ran this country in those days simply didn't know any better. I'm not saying that there are not any flaws in the system but until someone comes up with something better, I think we need to stick with what we have and try to improve on it. Legalizing all drugs is not the answer. IMO
However, I don't see the need to keep marijuana illegal simply because it's not a dangerous drug, provided the individual that's using it is not driving or operating heavy machinery. I think we could at least make it easier for an individual to access the drug if he/she truly needs it for medical reasons. Be it MS, Cancer or AIDS. It's my understanding the Marinol is totally unreliable and has some nasty side effects. Perhaps someone with more knowledge about that paticular drug can elaborate.
There have been some obvious benefits as a result of the system that's in place here, it's nearly impossible for an individual to get away with diversion on a large scale, especially for an extended period of time. Ask any doctor or pharmacist about the benefits of a tracking system and I'm sure the vast majority would agree that it's a good thing.
As far as the DEA being too rigid, it's going to happen. You're always going to have over zealous cops out there, whether they're traffic cops or DEA agents.
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