Questions about what is and is not considered "doctor Shopping"

[brycewise]

I live in Florida and was recently had a change in my insurance. I went to a General Practice as a new patient last week for treatment of a sleeping disorder and was prescribed Alprazolam .5mg by a physician. The prescription wasn't for any refills beyond the original. I am supposed to go for a follow up assessment at an affiliated pain clinic practice to be placed on a long term program (I.E. long term prescription). The impression that I got from the visit is that the goal was less about how to properly take Alprazolam safely and more about enrolling me in a program that would require frequent billable visits.

There was seemingly zero interest on behalf of the physician to answer any of my questions on how to properly take the medication.
E.G. I am also taking Tramadol for a recent surgery. I informed the physician of this and Its a good thing I researched alprazolam prior to my visit and learned not to mix the two... because the physician didn't seem to feel that was a detail I should be made aware of and made no mention of not mixing the two.

I will spare you the details of how it works for my particular situation but Alprazolam works for my insomnia better then anything I have ever tried, nothing else even comes close which leads me to my question....

Since Alprazolam (and probably other benzodiazepines) work well for my particular, problem but also have risks associated with their use
I would like to see another physician, to ask about being prescribed and taking a similar medication for the same purposes... but where the emphasis is on using the medication in a safe manner to get me to where I no longer require the medicine Rather then one that appears to be more interested in how much they can charge me regardless of whether or not the treatment is conducted safely, just as long as I keep paying for it.

How can I see two different doctors for the same problem, possibly be prescribed similar medications for the same problem, and not be suspected of "Doctor Shopping" and risk facing criminal charges in a situation where there is no criminal or unlawful intent on my part, but its where the intent is about treating a problem that causes me a lot of discomfort, and wanting to do it in a safe manner that minimizes the risk of a medication that's use is of great benefit to me, but also has the potential to be dangerous

Thanks...

 

[DeeDeeDrug]

Hey! I live in Fla too
Were you being seen for this by another dr before your insurance change?
When they do that, it usually means that they don't have an underlying cause for your issue so they are going to treat the symptom instead of a cause.

 

[Raysu]

Ok I think I'm understanding right: you got on tramadol for a surgery, got on alprazolam with a new GP, and are getting referred to PM? I can see this as being a way to cover the bases of two controlled substances by PM who has a contract most likely. The drug combo is not uncommon. Any opioid/benzo combo will state higher risks because the side effects can magnify since they are similar. Also most pharmacies have an interaction program in place and will notify you when you go to fill it if it is of great concern. And doctor shopping is seen as overlapping prescriptions from various doctors. If you change practices with no intent of returning and both parties are aware I see it as of no consequence. It is typically brought up by the doctor not insurance so if the doctors are in the know then no biggie.

 

[Keif' Richards]

Be up front with all of your prescribers. That's the only good advice we can give you. Honesty is your best bet for receiving quality care in the long run. Are you trying to say you don't want to tell the prescriber's about each other? Because that could potentially be a problem. There is however, nothing wrong with getting a second opinion.

 

[brycewise]

I was seen by another primary about 4 years before. She prescribed me Alprazolam and Lexapro. I liked her as a doctor but she was fixated on Lexapro, and it became a myopic view for treatment, despite my complaints. Her answer was " If 10 mg of Lexapro daily aren't working... then take 20 mg"... that's like saying if you just burned your mouth drinking hot coffee, try heating it up even more and see if that does the trick.

I had explained that while the Alprazolam worked, the Lexapro did not. I also have anxiety, but its anxiety about my having insomnia and the effects it has on me when I am sleep deprived. Since it isn't an all day thing, an all day "cure" if it works is going to be disruptive to my day if it is powerful enough to work at night, or it will not be powerful enough to effect me during the day and be ineffective at night too. I'm sure Lexapro is good for some people but it really just lowered my enjoyment that I used to get from activities I enjoy.

If you or anyone else takes Lexapro and feel like your passion, motivation, excitement...etc is missing from things that used to provide those feelings... its not you its the Lexapro. It took me two years to figure out that it was the cause and I would hate to see anyone else lose their own enjoyment for that long.

 

[brycewise]

I believe you're understanding my question. I have read about the risks, pros and cons of taking benzos, and how people typically use them. The typical use is for panic disorders and that's a different purpose then my use, which is anxiety that causes insomnia, but the anxiety is because I dread the impact that sleep deprivation causes me. So really its a self- perpetuating cycle in which either one (insomnia or anxiety) causes the other, and it has nothing to do with fatigue or how tired I may be.

So Its hard for me to come up with my own protocol on how to solve an immediate problem, by using a medicine that provides short term benefits, in a way that can translate into long term results. Since the only medication that works has well documented risks associated with its use and "behavior therapy" seems to be a waste of time, I would need to trust the person(s) who is helping me with that protocol. I don't trust the people I went to recently, I think are more concerned on how much I pay them then they are on how much what I'm paying for is helping me.

Since there is such Hyper vigilance surrounding controlled substance prescriptions right now, I don't want to face charges for violating new laws that have been put in place because some idiots keep dying from trying to smoke their pain killers, when my intentions are genuine.

I figured that If I disclosed all the info about my intentions and recent medications then its not doctor shopping, but I'm not sure if it will appear that way to the Doctor, Pharmacists or the DEA

 

[brycewise]

No, I will be honest with them regardless. I don't think I can expect to treat the problem if I'm anything other then honest, but with all of the hyper vigilance about prescriptions and "pill mills" I don't want to be lumped in with the prescription abusers and be denied treatment either now or in the future due to something that can be interpreted as similar behavior displayed by abusers, which it is, in a case where the possibly similar behavior is for different motives than those of abusers, which my motives are.