dr.shopping please help!

[candace101]

well i have been going to two doctors for two different things...i was worried when my first doctor got closed down...so i went to another...3 months later..my original doctor calls and says she is back in business...thats how it started...i was afraid she would close again..so until i was comfortable..since i have a broken back and i am addicted to oxcy 3o. i dont want to go thru that w/d ever again like i did when she closed. so for 4 months i went to both. i go to the pharmacy apparently i went to 3 months prior with my first doctor. when verifying my prescription the pharmasict asks the doctors office did they know i went to another doctors office 3 months earlier,and proceeded to tell her all the information about where i went . when i went, and the medication i recieved. i thought that was confidential? so the doctors office told her not to fill it,and to keep my precriptions and dont give them to me. i caklled the doctor and she said i was doctors shopping and so therefore i was being discharged from the office, no questions asked. i am so upset that the pharmasist gave that information out...and without question they keep my prescripotion,and im scared to death what happens now? am i going to jail? what if it wasnt me? and it was identity theft...here i pay for the visit and they just say to keep my prescription???who the hell gave that busybody worker at the pharmasist the right to tell all my business...whaT IF IT WAS ANOTHER TYPE OF DOCTOR? AND IT WAS  SEVERAL MONTHS AGO SO ITS NOT LIKE IT WAS WITHIN THE THIRTY DAYS. HAS  ANYONE BEEN THROUGH THIS? AND WHAT WAS THE OUTCOME? PLEASE HELP. IM SO SCARED I WILL LOOSE MY JOB.

[neednewknee]

I have a concern. I go to pain mgmt clinic for a chronic severe knee problem. I injured my knee severely playing ball in college and had problems ever since. I've had 7 surgeries and need total knee replacement but two doctors have told me I'm too young for TKR at 45. I was referred to pain mgmt to help manage this for a few more years until I can do the replacement. Prior to going to PM there were days I could barely walk and days it would buckle at work and I would have to get help to my car. Very humiliating. Even with PM I have episodes where my knee is so bad that my limping has now caused hip and back problems. Now that you have the background my concern is this...I often reinjure this knee. Due to the amount of meniscus, cartilage loss and ligament damage I can tear something simply getting in the car or misstepping in the yard. When this has happened, the pain is severe enough that my pain meds just to manage daily pain don't begin to touch it. The PM clinic I go to is horrible in that you can NEVER speak to a doctor there. All calls go to a call center out of state. Even in the one rare occasion that I got a call back they refused to increase my meds without being seen...in 3 weeks. So when this has happened I go to my orthopedic surgeon or primary care dr who sometimes give me a prescription to supplement what I'm getting from PM to help control the temporary increase in pain due to injury. I ALWAYS inform the prescribing dr about my PM clinic and hen immediately report  the added medication to my PM clinic with an explanation. A new dr joined the PM clinic and accused me of shopping for drugs. After lengthy discussion he finally understood but made sure to tell me to "keep my nose clean". Now I'm a nervous wreck. I've never gotten meds from anyone but pain mgmt, orthopedist or primary dr. And I've never attempted to hide anything. Anyone else experienced this? What options do people like me have when recurrent injuries happen between PM appointments that require more meds to control. I'm so grateful to be getting PM care because I was so miserable before that.  I am scared to death of doing something to jeapordize that.

[Tuckamore]

Hi Candace,

Welcome to the Pain Management Forum. First of all relax. Don't over-worry this situation. If you did nothing wrong you have little to worry about.

"Doctor Shopping" only becomes illegal when you are receiving two opiate prescriptions from two different physicians and filling them. If you have double the normal amount of opiates that you would receive in a moth this is considered illegal. Sorry...but these laws were put in place by the DEA to guard against distribution and the like.

As said by Optimus the pharmacist is required by law to report suspicious activity or they run the risk of losing the license they spent years and thousands and thousands of dollars to obtain. So don't blame them for doing their job.  

Unfortunately ignorance is not a defense if you have violated the law....however there are two sides to every story. Did you fill two prescriptions in a month when you should have only filled one thus receiving double the amount of an opiate?   If so, you may have some explaining to do. If you did not do this then there should be no further action taken against you. If you have a hint there may be legal actions coming then I would run to an attorney before you even speak or discuss this with anyone. I am far from an expert. These are just my personal opinions.  

Return to your remaining PMP and be honest and upfront. Explain what you have done and why and also tell the consequences that have resulted from your actions. If I understand your post correctly you saw these PMP in different months....but didn't over fill the opiates...or attempt to obtain more opiates then one APMAP would have prescribed in a month. You should be okay but again you have to confess to the PMP what has occurred.

I'd also write a letter to the PMP that dismissed you, explaining what happened and why. Include a print out from the pharmacy that proves you did not obtain more then you would have received had you only seen one PMP. In all probability it won't change the fact that you have been dismissed....but your written explanation will become part of your medical record and will be there for future reference. Also take a copy of that letter to the PMP that hasn't dismissed you. Don't run...be open and honest, even if it hurts. In the long run you won't be sorry. It should all turn out okay and chalk it up to a hard lesson learned.
Unfortunately FL has had more then it's share of abusers...and the pharmacies have been placed on high alert for possible abusers. This effects the non-abuser like you and me. We pay for the few (both physicians and patients) that have abused the system in the former chronic pain (CP) friendly state. In many situations/areas in FL it has become very difficult now for true CP patients to obtain good pain management. The few "pill mills that still exist are rapidly being closed and the legitimate ones are jumping through hoops to continue their good practice. They are also required to pay (out of their own pockets) dearly for surprise record audits conducted by the DEA /state to prove they do follow the laws and prescribe responsibly.

I hope you will let us know how you are doing and share with us the outcome of the your current situation. I wish you the very best and hope to hear from you soon.

Peace,
~Tuck

[optimus22mac]

Did you receive prescriptions for the same medication from two different doctors? That is illegal.  It also is the pharmacy's responsibility to report if someone is receiving medication from multiple doctors.  I am wondering if you had prescriptions from both doctors at the same time? I am just confused, are you seeing both doctors right now and getting prescriptions from both? Or is one of your doctors a former doctor of yours that you will not be returning to.  Are you using the same pharmacy all the time? You say you have a broken back, but you are working...are you recovering from a broken back, or a surgery? And you also say you are addicted to your medication...are you actually addicted or are you dependent? I cannot speak about the laws in your area, or how the pharmacies and doctors are set up, but in many places, they are linked by computer, so each pharmacy knows where and when you fill all of your prescriptions...especially when they are narcotics.  Pharmacies are usually supposed to verify narcotic prescriptions with doctors, and if they have filled prescriptions from a different doctor within a certain time period, they are obligated by law to notify the doctors.  There are quite a few regulations that the DEA has placed uopn doctors and pharmacies that have gotten even stricter as of late, so they all need to cover themselves, because they can be fined or lose their license for filling a prescription that may overlap with another.  If you are saying that your old doctor has not written any prescriptions for you in over 3 months, and you always get your prescriptions at the same place and they never overlap, you should be able to get a print out to show to your doctor to clear you of any wrongdoing.  I know that withdrawals can be awful, so I hope that you are not out of your medication yet.  What are you taking, and what amounts? If you do believe that you may have broken the law, you should be aware that you can be prosecuted for doctor shopping, or similar offenses.  I hope that I have been a little helpful, if you provide us with a little more info, that may make things clearer...I can tell you are very scared, so I am glad that you sought out the help of the forum.  If you have done nothing wrong, you should be able to clear things up with your doctor, and I would try to call for an appointment in the morning.  Are you seeing a PMP or a PCP? Did you sign a contract?