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  • BDD Moderators: Keif’ Richards

Is this Doctor Shopping? Can someone get in trouble for this?

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creznor

Greenlighter
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Feb 18, 2014
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Hello,

I have a question regarding "doctor shopping" in the state of Florida. In Florida, the statue for "doctor shopping" reads as follows: "To withhold information from a practitioner from whom the person seeks to obtain a controlled substance or a prescription for a controlled substance that the person making the request has received a controlled substance or a prescription for a controlled substance of like therapeutic use from another practitioner within the previous 30 days. [Florida Statute Section 893.13(7)(a)8]."

Hypothetically speaking, let's say a person decides to visit the Emergency Room of a different hospital each week for one month -- again, hypothetically speaking. The person has a legitimate, observable medical condition (not some phantom aches and pains): a protruding, impacted, abscessed wisdom tooth that's infected and has a giant black hole of a cavity. The patient is visibly in pain and describes his symptoms to a tee, but never makes a request for any specific pain medication. He is given a 5-day supply of a narcotic pain medication during each individual visit nonetheless. Each time the patient runs out of said medication, he returns to the ER.

According to the statue, one of the conditions that constitutes "doctor shopping" is that the patient "makes a request" for a controlled substance for one that was already given within the 30-day time range, but the patient never requested anything. Neither did he make mention of previous narcotic pain meds. that were prescribed to him. He simply came in and described a set of symptoms to the doctor whilst grimacing in pain, nothing more. Has a crime been committed/can the person be convicted of "doctor shopping" since he never made the request to obtain anything? If yes/no, why exactly? I asked this on another forum and most people agreed that it did infact constitute "doctor shopping" because the fact that the patient showed up in pain was an "implicit request" for pain medication, but the statue specifically states and seems to be focused on controlled pain meds; surely, there were other "non-controlled/non-narcotic" pain meds that could have been prescribed, such as prescription grade NSAIDs like Toradol, Motrin 800 or Naproxen, Neurontin, or Tramadol.

I ask because SWIM's situation is very similar to the scenario described above and is afraid that he will be called out on it and/or confronted by an ER physician -- or worse -- if he makes just one more visit to even the same hospital complaining of the same ailment in the upcoming future. SWIM does not have a regular PCP nor health insurance... and has but one traffic ticket (a clean record); the last thing SWIM wants is to be considered a felon at such young age. Is SWIM in the clear?

Thank You
 
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You are going to the hospital with the expectation that they will help you somehow. It doesn't make too much difference whether or not you are specifically asking for pain relievers. Look at your discharge papers- they should make a recommendation for you to follow up with a primary care provider. It would not be in your best interest to hospital-jump and we can't help you circumvent the system. If you seriously need medical help in the future, this looks bad for you as your "toothache" is in their records. Also, we don't use Swim here.
 
As someone from florida the answer is yes, it will get you into trouble. You are knowingly going to a different place each time with the expectation of getting pain meds hopefully and are going to a different place each time because you know they wont do the same twice anywhere.

At some point if any doc happens to pull up the state prescription monitoring program anywhere and they will see that you have been getting narcotics from a variety of places in a short period of time you are done.
 
missmeyet? said:
As someone from florida the answer is yes, it will get you into trouble. You are knowingly going to a different place each time with the expectation of getting pain meds hopefully and are going to a different place each time because you know they wont do the same twice anywhere.

At some point if any doc happens to pull up the state prescription monitoring program anywhere and they will see that you have been getting narcotics from a variety of places in a short period of time you are done.
Click to expand...

^^ Seconded. I went to two different hospitals where I live here in Western interior of Canada.. I ran into the exact same BITCH doctor TWICE at 2 different hospitals who doesn't have ONE clue about benzodiazepines or Opiates. I'm not sure about the United States, but the doctors here are NOT very well trained when it comes to tolerance and addiction. Its extremely hard to get a prescription for ANY bezodiazepine where I live, we are the most conservative province in Canada, and its absolutely ridiculous for a City with the population of over 1.4 million and climbing - there are no treatment centres in the City, only 1 Detox Centre, that is useless. I have the same meds as they use, so no point in going there for the second time either. Anyway, I got lucky and finally found a doctor thats actually right near me which is good until I finish my schooling so I can move somewhere else in Canada, or Southern USA if I can.

Anyway, this BITCH doctor I saw at the 1 hospital (The Foothills Hospital) who just gave me an IM shot of 15mg of Morphine with 25mg of Gravol mixed in... LOL this is when my tolerance was at 600mg/day of Oxycodone orally. My tolerance is even higher now, Morphine and Hydromorphone barely touch me. Well HydroMorphone helps fentanyl withdrawals a lot more than Morphine or Oxycodone...
Then I saw the same doctor about a year later or so and she accused me of Narcotic shopping and Benzodiazepine shopping. I never ONCE asked her for benzo's, I already have an 11 year benzodiazepine habit now, and had benzos. I was in search of Narcotics yes, because my regular doc was gone for another week.. So anyway, this BITCH doctor, I can't remember her name now. She REDFLAGGED Me.
and put in the EMR (Electronic Medical Records) system that I was a Drug seeker seeking Benzodiazepines + Opiates. Boy am I fed up with our medical system. Its disgusting here.

I don't think where you are in Florida, you have to worry about doctor shopping (including going to the hospital). I honestly think you will be in the safe zone, since Florida is one of states in the US that still handout opioids and benzo's quite easily.

You try and get a benzo here, doesn't matter what you tell him, even if you were having panic attacks all the time, and couldn't work because of the issue, at most they will prescribe you Clonazepam. You are either going to get, Clonazepam most likely here, Lorazepam 0.5-1mg (very rare to get the 2mg sublingual by wyeth - my fav!) and if you are lucky you will get scripted Diazepam. But if you think you will ever get Alprazolam (Xanax) scripted here -- look the other way, because its not going happen unless you run into a rare really good doctor.

Anyways, sorry for the rant. Was just explaining a bit how are system works, compared to you guys down in the US.
 
Ok..then what is the point in going? Trust me..if you write no narcotics on there then they are NOT going to give you any.

And to Supeudol...for several years now Florida is one of the toughest states to get any controlled substances in. Ever since they shut down the pill mills several years ago it is almost impossible for even regular pain patients to get their normal prescribed meds...just google pain patients in florida and you will see...they have a prescription monitoring program and have made a point of making it the toughest (one of) in the US.

*edit*
so yes i agree, it would be an implied request because what else is the ER going to possibly do for a bad tooth but give pain meds? Especially if you never followed up with an appt with someone who could do something to fix it...trust me..i have been im similar situation. (I have also been a nurse for 20 years)

For supeudol

http://rt.com/usa/florida-painkillers-black-market-583/

http://articles.orlandosentinel.com/2012-07-10/health/os-drug-shortage-20120710_1_pain-patients-prescription-drug-abuse-oxycodone-pills

https://www.drugfree.org/join-together/community-related/florida-combats-prescription-drug-abuse-with-laws-and-enforcement
 
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What about if the patient writes "No Narcotics" on the patient intake form upon arriving at the ER and also tells the ER physician that they don't want to be treated with any narcotic/controlled pain medication? Again, the statue places an emphasis on patients who seek to obtain and/or request controlled medications (To withhold information from a practitioner from whom the person seeks to obtain a controlled substance or a prescription for a controlled substance that the person making the request has received a controlled substance or a prescription for a controlled substance of like therapeutic use from another practitioner). So if the patient visits an ER again, rejects narcotics/controlled substances, and say... requests the non-controlled/non-narcotic "Tramadol," how the heck would that fit Florida's definition of doctor shopping if the patient wasn't seeking to obtain a controlled pain med (Tramadol is not a controlled substance in Florida and is very effective for the patient)? Do you see where I'm coming from?
 
Thats fine for that occasion..its the five prior times that would be a concern. The fact that you made a point of going to a different facility each of the prior times and also did not mention that you had been receiving narcotics all of those other times to the ER doc at each subsequent one is what would be the concern. But for future reference as long as you make a point of not getting anymore. If tramadol works for you then go for it.
 
So just to confirm what I'm trying to get across: if "the patient" shows up at the ER and either makes a written/verbal request for a controlled pain medication and/or is prescribed a controlled substance regardless of any request, he/she MUST legally, voluntarily disclose the fact that he had been prescribed controlled pain meds within the past 30 days from different physicians; if the "patient" shows up at the ER and makes a request for a non-controlled pain medication (i.e., Tramadol) and/or is prescribed a non-controlled pain medication regardless of a verbal/written request, he/she is not legally obligated to voluntarily disclose his/her controlled pain med history within the past 30 days and would therefore not be in violation of the "doctor shopping" law. Is this accurate?
 
Well legally you would not have to state it if you dont receive any narcotics..but a doctor expects you (especially because you sign a "patients rights and responsibilities" form each time in your paperwork) to tell them any pertinent info, ie, i have been to the ER 5 times in the past month and have recieved X, Y, and Z meds each time.

And even if you say no narcotics but expect maybe tramadol (which a lot of docs see as narcotics even though in florida it is not scheduled..it is in a lot of states and most docs train in other places)if they happen to look at the patient presciption monitoring program on the computer they may question you about why so many different facilities and why you havent went and tended to the problem. When you say no insurance is the reason they will hand you a list of low cost dental offices/clinics.
 
I guess im not sure what you are wanting someone to tell you...are you wanting someone to say no you have no chance of getting into trouble from already going to so many different facilities in a short period of time? Because there is a chance of it..but it is not as likely if you dont do it anymore. Most likely the worse that will happen is they might end up redflagging you for anyone in the future who looks at the system statewide to see some questionable activity has been going on and you might get embarrassed when it comes up.
 
Why don't you just fix the toothache? You know, go to an oral surgeon. If you're nice, he might even give you nitrous. :o
 
basic drug discussion is for drug specific harm reduction questions. the guidelines clearly state that questions regarding doctor shopping are not permitted, even in a hypothetical scenario.

closed. please pm me if you have any questions.
 
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