I work in a health center, essentially within a primary care practice. I can offer some insight as to what may be happening in both OP's question, as well as more generally with some of the points
@JackARoe makes.
Most states (maybe all, I'm not actually sure) require providers to cross reference controlled substance prescriptions through a controlled substances prescription monitoring program (PMP) - this is done by both the authorizing prescriber, and the authorizing pharmacist. Whenever you fill a prescription for any controlled or listed medicines, this information gets uploaded immediately into that database to be available for cross reference. Doctors are required to look you up before they write you a prescription for controlled substances, as is the pharmacist who is filling those prescriptions. This is to prevent people from doing things like taking a copy of an Rx to multiple, separate pharmacies, paying for their medicines in any mixture of insurance and cash, it would alert prescribers whether there is another prescriber who is also issuing a prescription for a similar or contraindicated controlled substance, and it lets pharmacies see this as well.
For reference, about 15 years ago I was a heroin addict who knew pretty well how to talk to doctors. I was able to get two different prescribers to write me for the following Rxs:
Ritalin (methylphenidate)
Ambien (zolpidem)
Suboxone (buprenorphine)
Klonopin (clonazepam)
Ambien CR (zolpidem)
Focalin (dexmethylphenidate)
Tranxene (Clorazepate)
I filled these scripts, sometimes on the same day, across the street from one another at a CVS and Walgreens, running the cheaper generic drugs through as cash fills at walgreens while putting the others through on my insurance. The only way that anyone could have noticed this was if they contacted my insurance company and inquired as to what medicines I'd been prescribed, and even then, it was only some of the medicines some of the times that I'd run through insurance. As most of this information falls under some form of patient confidentiality protections, it became very easy for people to end up getting multiple medications that could be harmful to that person, prescribed to them. This could happen intentionally, as was relatively true for me (I initially didn't know that this was the case, I found out only by accident as I was planning to change psychiatrists to the suboxone prescriber, only to realize that I could just go to see both of them and they wouldn't have any idea that they were both writing me prescriptions...) - this could also result in someone thinking they are doing the right thing, going to see multiple prescribers and having strong medications ordered that interact with other medications. With the number of different pharmacy chains and lack of centralized health records, it's easy for this kind of stuff to be lost in the mix. It's frankly one of the contributing factors to our current problem with opioids in the US - not the only factor, but certainly one of them.
The problem with PMPs is that as a patient, you are being judged by the person reading that database. When your name is checked in the database, someone might see that there are multiple attempts to fill a prescription at different pharmacies, and they lack the context as to what was happening in that situation. On top of that, the DEA will publicize its efforts to go after prescribers for their controlled substances practices, and this puts the fear of God into anyone who has chosen medicine as their career. As a result, providers are put in a position where they aren't always given the best information because Big Pharma pushes one way while the DEA slices another, and the patient (you) is left wanting the expert (the doctor) to just give you the correct medicines that work. What also affects this is that your doctor has other patients who maybe pushing to get their prescriptions changed,, increased, faxed over to another pharmacy, for seemingly malicious, or potentially benign, reasons... it's a quagmire.
Most prescribers have backed off hard on controlled substances as a result, especially opioids. It's a real shame because a lot of people with real pain and no options ultimately are pushed to turn to illicit markets to source pain medication which are incredibly saturated with fentanyl, to JackARoe's point.
The one tricky part about all of this, is that these ARE addictive drugs, and the person who is receiving the drug is often the last person to be able to see a problematic pattern developing. It's a moving target, honestly. I had an issue years ago where I was taking zolpidem for sleep (ambien) - I was taking 10mg at night, as prescribed. Once in a while I'd still have trouble falling asleep so I started taking a little extra piece, and because zolpidem is a schedule 4 controlled substance, I was able to fill it a few days early, no big deal. My doctor at the time was not really that invested in how often I was taking this medication, despite knowing that I was a former polypharmacy addict (as previously mentioned), because he was on the back 9 of his career, dealing with increasing pressure from his bosses to see more patients, convert to electronic medical records, and I was not a huge problem patient for him. I was young, relatively healthy, and the only controlled drug I asked him for was ambien, so he would happily refill it whenever.
One day the pharmacist at CVS gives me a hard time, "you're filling this too early, quite a bit". I was? It's no big deal, I told my doctor I sometimes take an extra little bit, it's fine - "It's not good! You shouldn't take more than 10mgs of this, it's not recommended for dosing above that level". Now, I could sit there and justify why I was doing what I was doing six ways to sunday, but in the end, he was actually 100% correct. I was taking a medication that is recommended for use as a Short Term treatment for insomnia, (14 days, my insurance actually only pays for 14 pills a month though I can fill it for 30 days if I paid out of pocket) and I was taking this medication for years on end, and I had increased my use to the point where I was taking 1.5x what I was supposed to take.
I had worked my way into developing a reliance on zolpidem for sleep that, while not heroin or the prescription drugs I had once been addicted to, was still not a good path for me to be on, and it took that pharmacist noticing that I had developed this pattern that I had missed, my doctor had missed, and pretty much everyone else involved in my care had missed.
It's for these reasons that having checks and balances is important, and it's also really friggin' hard to know what the right way to handle these situations is.
I hope that this is helpful to someone.
It's an awful situation honestly. All I can suggest is to develop a good relationship with your prescribers and your pharmacists, and if you have the option of having a care coordinator at your health center, (often a nurse or some other allied health professional who can speak on your behalf), to take advantage of that. Medical professionals are much more at ease when talking to another medical professional about complex and risky medication issues. Having one solid person in your corner can mean the world for making sure that your care is provided, and it also means that you have someone who can tell you objectively that you might be overusing, misusing, or becoming unintentionally dependent upon a medication. When that person is not a loved one or the person who is writing you prescriptions, it's a lot easier to have an open and honest conversation in the event that something like that were to happen.
Best of luck
