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  • NSADD Moderators: deficiT | Jen

What really happens when someone is "labeled a drug seeker" in the U.S.?

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You're probably right but it'd be better if you told us the source of this information.
 
^ I think that not being able to find a source that says there is a universal database for drug seekers may be proof that one doesn't exist. I think it would be harder to find a source that says that something does not exist as opposed to finding a source about something that does is exist.
 
37 states now have implemented a PDP in some form or another. I live in Indiana and they require anyone issuing scheduled medications to submit a report of what was prescribed within 7 days. Along with this, a practitioner can request a report on any patient they are treating which will show a list of all medications they have been issued. As far as HIPPA goes, they state that "numerous safeguards are in place to protect confidentiality" and give this list as people who can access the information.

Licensing Boards engaged in an investigation of a licensee

Attorney General's Office, if they are involved in an investigation, adjudication, or a prosecution regarding a violation of state/federal laws concerning controlled substances

Law Enforcement, when an investigation involving an individual or proceeding involving the unlawful diversion or misuse of schedule II, III, IV or V controlled substances, the information obtained must assist in the investigation

Practitioners who are providing medical or pharmaceutical treatment, or evaluating the need for providing such treatment, to a patient.

It seems to be it would be quite easy to be flagged nowadays, it's just a matter of how soon it would happen. All of the information on your states programs should be available to the public online.

Like one poster said, you may just get flagged by the doctors at which point they would cease any further treatment. I have also researched on similar sites to this and found people whom were arrested months or years later for "doctor shopping". I think that's the most extreme situation obviously but it's enough to keep me from doing it.
 
Why should it not be appropriate? It's a really bad problem in the U.S. for CPPs - Chronic Pain Patients (there are 116 million CPPs who are untreated, poorly or incorrectly treated). I ought to know - I've been one now for 29 flippin' years! In fact the VA almost killed me around that, and they did, I'm morally certain, shorten my late wife's life by crippling me. The VA has a set of DSB criteria (Drug Seeking Behavior) that will eventually nail anyone on regular opiates. If you're a pain patient especially, you're screwed. Technically they review your DSB status every 3 years, but the letter I got from the head of the DSB board said, "We will remove the red flag when stop acting like an addict." That means when I stop needing opiates to control the pain. Just fyi, I have "massive nerve damage," severe arthritis and severe and crippling chronic pain. I've had 6 low back operations, at least three of them botched. There doesn't seem to be a lawyer on the planet with the cojones to sue the VA either. The VA's own directive (their standards for medical treatment) agrees with the civilian one, but the DEA has its own and they ignore the actual medical science behind CP treatment. They've learned that doctors and small clinic don't shoot back, and since they can steal assets even before a doctor has been charged and leave the doc destitute, it's seriously profitable. They share the money around to local cop shops, the school boards etc., so everybody gets at least a taste. The first thing they do once they've decided on another "Pill Mill doctor" bust is call the local media and make they're there. (This doesn't contaminate the jury, they say). They attack a clinic in full SWAT gear, drag half-dressed patients out of exam rooms and them and the patients and kids in the waiting room at gunpoint (gotta watch those little kids; they might haul an AK out their diapers and start blasting away!), steal patient records (another way to be sure no doctor will see the patients that are now medically abandoned). Normal billing practices becomes "money laundering," and regular opiate scripts or "high-dose"opiate treatment become "knowing and deliberate over-prescribing for no legitimate medical purpose." The DoJ prosecutor (especially in the case of the Pain Relief Network) as well as the Federal Judge are both vindictive and complicit, looking for another major media event. A judge can go into politics on it, and the prosecutor gets a lot of publicity as well. They go after mostly older doctors who've had some time to accumulate a home, a clinic and other property, maybe a boat and a small plane, savings and investments, they take it ALL so the doctor has no way to pay a decent lawyer.

The story is there at the remains of the Pain Relief Network and on doctordeluca dot com. The PRN is no longer a treatment advocacy organization (it was a (501)(C)(3) non-profit for that purpose, but the prosecutor beggared the surviving (until this last Christmas; she died in a small plane crash with her fiancee, an ACLU lawyer who helped in the case) founder, Siobhan Reynolds and the PRN nonprofit, so the blog is just there as a CPP chat for moral support and education. There are a lot of great exchanges and tons of information there, but that's it. No idea how long it'll remain up. I was a moderator, and wrote a lot of article and posted a lot. I'm one of three Administrators now.

Anyhow, once someone is labeled a "Drug Seeker" or there's an ADRB (Aberrant Drug-Related Behaviors) flag on the chart, the patient is reduced to begging for 30 Tylenol #3s for chronic pain. If it's the VA, the opiates can be precipito9usly discontinued, and the patient required to go through an "addiction evaluation." Every time that's happened to me, the "rehab center" they sent me to tossed me out after a couple of days with a note to DSB board that I had a pain problem, not an addiction problem. The Board always ignored it. An early experience at Sepulveda VA, defunct since the Northridge earthquake, was that they cut off the opiates, no titration at all, and when I went into withdrawals the doc in charge said, "See! You're an addict!" We had an Olympian fight over that and when the senior addictionologist came in he removed that and threw me out.

I was on fentanyl for some years and had been on a correctly titrated opiate regimen for a total of eight years before my wife became terminally ill, about 4 years ago. I had improved to where I was playing music on the weekends, helping out with a good-sized garden, trapping and relocating skunks as needed (and caring for feral cats and hauling them to the vets too), helping with cooking and housework - carefully. Right when my wife became bed-ridden, a new doc I had never met got the refill request for carisoprodol (generic Soma). The script had had a date limitation on it, but assumed I'd just bought 'em and scarfed 'em all down because I'd asked for a refill after the date ran out leaving a few hundred left I could never pick up. He actually called on the phone to tell me I was abusing them so I was off them as of right now. He refused to listen to me OR my regular doc when he got back from vacation. I was tricked into seeing a "Board Certified Pain Management Specialist who was no such thing - just an Internist with a year at a pain clinic. He cut the opiates I'd been on by more than 50%, removed the breakthrough pills ("You can't have a weak one AND a strong one - it's one or the other!") which is all totally contrary to the Medical Standard of Care and the VA's own directive. He crippled me, and I was only caretaker my bed-ridden had at the time. My house became toxic along with our clothes. I just couldn't do all that still feed and clean her. It got so bad we decided to take our own lives. We were about a week away from that when a local doc gave me enough help that I was able to keep her in the house she grew up in until she died in my arms, both as she'd wished. My weight, meanwhile, had dropped from 210 to 143 lbs - I'm six foot two. I'm still recovering.

I was recently remarried to a wonderful lady with six kids, three of whom are with us and three with the father by their own choice. We're looking hard at moving to Panama, a place that appears to be a lot more sane around pain treatment. I can't go through that again. I'm still not sure I've survived that last round of abuse. I'm back at the VA for non-pain related treatment ONLY. I have a pain doctor I see once a month, but I'm not sure how that will last either. He's been talking about a school he's going to and says he'll likely leave the field, and there ARE no other pain docs around that I'm aware of. Also, the DEA seems to be winding up for another country-wide "Pill Mill doctor" hunt. They'll be leaving the field in droves, not that they ever really quit - just slowed down.

A DSB or ADRB file is a medical blacklist. It's used that way, and once on it I've never seen anyone get off of it. In the VA records, that flag is still the very first thing that anyone accessing the file sees, and they have to sign in with their own SS#, which gets recorded on a permanent record. Or so I'm told.

My rant aside, did I answer you? Pardon if I ran of at the... ?... mouth? keyboard? Whatever. Anyhow, for whatever it's worth, there it is. There's a lot on Doctor DeLuca's site about this, and it's searchable. So Nvwhtohiyada - Cherokee for "Peace to you!"

Ian
 
Wow. I'm sorry that you have to go through all of that Ian. Your story showcases exactly what is wrong with the system. Thanks for sharing that and welcome to bluelight.
 
I suspect I've been labled a drug seeker because I've gone to four doctors for ADD after my psychiatrist moved and the first thing they said was,"We don't give out adderall!" And I didn't even ask for it, even suggested strattera or intuniv instead they said," It's all speed!"(dumbasses)

I have to use a medicaid program, and while I was in a hospital I admitted to drug use while I was weak and fucked up on 5 different drugs they gave me(stupid!). I think it's stuck in my records. Am I screwed?

Moral of the story, don't tell any medical professionals about your drug use if you don't have to, unless it's may be causing health problems or you want to quit forever.Not even weed, because they'll think you might be more likely to abuse it or sell your med for weed. I'd be nice if patients could be honest about their drug use, but between the lawyers, government and insurance companies doctors don't really have a choice.
 
I have a quick question, I'm going into rehab next Monday. I know I'll be seeing doctors there but this is my first time trying rehab. Will the fact that I even went into rehab be in my medical charts that say, my family physician would see?
 
^ Nope, there's a lot of strict rules regarding rehab. I went to rehab and no doctor has ever known it unless I told them. Just try and read all the paperwork that they make you sign, so you don't sign anything stupid. I went to a really nice rehab though, it was around 45k, but did absolutely nothing for me. Good luck man.

On another note, Georgia can be added to the list of states with a prescription database.
 
Yes, within a specific provider, Doctors Office, Medical Group, Hospital and Insurance Company they have codes for diagnosis that are primarily used for billing purposes. This is a very complicated system used to communicate between Providers and Insurance companies hence the need for specific schooling to be able to do medical billing. So yes within an insurance company or a provider they may have a database with this information however it is only limited to that specific provider or ins company. There is no universal database with everyone’s information in it.

Many Doctors do ask for medical records, but it is up to you to tell them where to get them and you have to sign a waver allowing them to get them. Doctors have no way of hunting down your medical records without your permission, even within specific hospitals or providers they still require you to sign wavers to retrieve your medical records, but a lot of them have internal systems that list the dugs you are prescribed and so forth.

I will say it again; there is no universal database of everyone’s medical history anywhere. It just does not exist, and even if it did you would have to specifically give permission for anyone to access that information.

END OF STORY!!!!!


Sorry I forgot about this post. I will ask questions and find out some info. I will post when I find out something.
 
the kasper system is supposed to monitor scripts, and keep pharmacies informed about your narcotic scripts. but really, if your dr. keeps writing them out for you, theres nothing they can do. i mean, if you go to the er all the time, then that er will blacklist you, or give you the "toradol" treatment....or if you go to different docs and get multiples of the same drug, then the pharmacies wont fill them. dont be stupid, is all i can say...theres so many stupid careless people out there who are all over the place and sloppy who make things harder for those of us who are chronic pain sufferers, dependant, and need certain meds to live life, but im not preaching and i dont really judge, whatever...just be smart and informed. its the pharmacies that will block you not necessarily the dr.s, theyre so busy nowadays...most dont even know who you are until they have their laptop opened in front of them.
 
Rehab ruined my life

^ Nope, there's a lot of strict rules regarding rehab. I went to rehab and no doctor has ever known it unless I told them. Just try and read all the paperwork that they make you sign, so you don't sign anything stupid. I went to a really nice rehab though, it was around 45k, but did absolutely nothing for me. Good luck man.

On another note, Georgia can be added to the list of states with a prescription database.

I had been taking pain medication as prescribed by pain management doc for about 15 years and decided that the treatment might be worse than the pain. I then made a disastrous decision and went to a detox/rehab center to get off the pain meds without having to go through withdrawal. Once out of the rehab facility, I found out that every doctor, er, urgent care facility, etc knew about the rehab and would no longer prescribe me any controlled substances. This included the klonopin that I had been taking for 9+ years. The rehab center took me from 4 mgs per day to 0 in 9 days. Needless to say, I was still in very active withdrawal after leaving rehab. I finally found a pain doc who also does suboxone treatment to withdraw from opiates. So that he could be sure which withdrawal symptoms were which, he put me back on klonopin and suboxone. After getting me out of withdrawal, he is keeping me at the same suboxone dosage and is tapering me off of klonopin. I think he is still going too fast(reducing daily dosage by .5 mg every 5 days) but it should be better than the previous attempt. Once I am off klonopin, he will start a suboxone taper.

If it matters, this is in NE FL(Jacksonville area).
 
^ Nope, there's a lot of strict rules regarding rehab. I went to rehab and no doctor has ever known it unless I told them. Just try and read all the paperwork that they make you sign, so you don't sign anything stupid. I went to a really nice rehab though, it was around 45k, but did absolutely nothing for me. Good luck man.

Same, I've never had any problems with it since. I've had to tell docs on multiple occasions not to give me benzos. I'm not sure how the whole system works, but there's definitely no master list-it's hard to say how unified they would though (like, your insurance company's list is obviously more comprehensive than one doctor, one pharmacy, or even one state Rx monitoring system..)
 
I've had similar experiences with the VA...I started using the VA hospital 10 years ago and they go back and forth with me all the time. At one point they convinced me to go to the VA dual diagnosis rehab. Big mistake, without warning they just took away the klonopin I had been on for 2 years and I had to go through those withdrawals while in rehab, it made it so much harder. Then it took a year or so to get them back after "treatment" and going through a "reassessment"...ten years later and the first thing any new psychiatrist from the VA, regardless of what state I'm in, I move sometimes just to see other areas of the country for a year or so, starts off asking me about my drug use and make me pee in a cup before I even see them...they always question why I'm on the meds I'm on and why I get so much of one and just a little of another...it's not so much insulting, because I did, many years ago, have a serious problem, but it is humiliating to have to go through it every time. I had one even yell at me that I was "just some huffer junky" because I had admitted to using nitrous recreationally 8 years ago, she threatened to take any narcotics I was on away...eventually we made a connection and came to an understanding but it took months. It always puts me immediately on the offensive and I will flat out lie to them, which I hate to do, usually I'm pretty open with my psych about what I'm up to, that's what they're there for. But, when it's all focused on the past drug use and not the emotional problems I was trying to mask with the drugs...I can't help but feel like I'm walking around with a neon sign over my head that says "ADDICT". I just moved recently and started going back to my old VA facility and it was the same all over again...I have the money and may just stop using the VA all together, go and pay out the ass for a civilian dr so I can have as fresh a start as possible, but as has been said in other posts, they will want me to sign my old records over to them and if I don't...that's just another red flag...
 
I always wondered about this as well. Especially as a suboxone patient I wonder if my insurance company would stop me from filling narcotic prescriptions.



I think that is the biggest obstacle in stopping people from receiving multiple prescriptions for narcotics. I don't think insurance can stop you from filling them, but they might attempt to contact a doctor to confirm they know whats up and make sure they know. Though that might be a violation of health care privacy rights. Or the only thing they can do is contact the doctor who prescribed the narcs and make sure its legit.

My guess concerning most people who "doctor shop" is they would not use insurance to fill their prescriptions. Now they are clearly going to pay more for it, but if you think about street value of these medications, its still much cheaper to pay full price for the generics(or even non-generics) from a pharmacy. I can't confirm this, I haven't filled a legit narc script (aside from subs) in over 10 years, when I got some Vicodin for my wisdom teeth.


In regards to the VA, i am not a verteran and so obviously have no direct experience with them. But I have worked for an ambulance service that provided service to VA patients and I have no always been impressed with the care they have received. I also know veterans who have had their issues with the VA. All in all, I think the VA is a completely different beast than dealing with a local doctors office.
 
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I just joined because I wanted to give my 2 cents on this. For me it seems like a pharmacy could put a note in your computerized file labeling anyone as displaying drug seeking behavior for a number of reasons. I think it may have happened to me a couple years ago. I had refilled a class 4 controlled prescription a little early a few times. This was known by my doctor. I had complained of increased anxiety and/or tolerance after 5-6 years at same dose. He said "I would prefer not to increase your dose, but don't mind if you need an extra pill on a few days each month". Well that winds up with needing refills at or around 25 or 26 days in my case. My pharmacy always filled them without hesitation until August 2013. Everything changed when I ran out. I had no refills left but had a new rx with 2 refills on it. I took it to the same pharmacy. When they looked up my name after I handed them the rx the tech went to ask the pharmacist a question. She comes back and informs me that it is too early and I must have 8-9 pills left at home. They made me wait until 31 days from last fill which put me in the most uncomfortable position of benzo withdrawal. Not to mention my morals and character being doubted. I made it through and immediately changed pharmacies to one I had used when I was married and near my ex wife's home. I asked specifically how soon can this rx be refilled and explained what my doctor had said. They told me the DEA is cracking down but I could refill on day 27. I have not had any problems since then. I'm not blaming anyone for my week of hell but think that if pharmacy A has been filling this med for me every 25-26 days for years they could have told me prior to Aug 2013 that new laws prevented less than 27 days. Also they could have told me I was 2-3 days early and could fill on day 27 rather than take their frustrations out on me making me wait 4 extra days. I know pharmacists are always being conned by much worse than me. I have witnessed several encounters while waiting in line or waiting the 30 minutes for my rx. People saying anything, begging, lying, etc. I thought that I had done the right thing by telling my doctor as soon as I noticed the need for an extra pill from time to time. Just a side note: the new laws on opiates have had disastrous consequences. The oxycontin abusers/diverters forced all true law abiding patients struggling to get pain meds filled while at the same time turning pill abusers into heroin addicts. I see this as counterproductive. Who knows what their getting when purchasing heroin from what I think are the ultimate scumbags; the street dealers. Since the crackdown, heroin use has skyrocketed and kids are dying every day. It just seems like they made what was a significant rx/law problem into a massive national epidemic. More death from overdose, AIDS, shootings, etc. While I don't condone pain med abuse, I understand how it happens. What I can't tolerate are the people who profit from selling either pills or heroin to anyone. How can one sleep at night knowing that he or she is turning peoples lives into hell??
 
I am not sure how it works, but there is a system called HIE (health information exchange) that allows Doctors to communicate patient records. The Hipaa Law only keeps people who are not doctors or physicians that are or have treating/ed you from looking at your records. Some states have an opt in opt out law that allows you to decide whether or not they can share your records. Hospitals can share records with any doctors that they are affiliated with even if you do opt out. In most consent for treatment forms that we sign at a Doctors office will say that you give consent to treat and allow them to share information with any doctors, hospitals, etc. that are involved in your treatment. The laws for mental health and substance abuse treatment are a little different though. The reason I know this is because not to long ago I was being treated for substance abuse, then over the winter my hands became white then purple then normal, It scared me and i went to the ER, when i was there I had told them what was going on with my hands and that I had been being treated for substance abuse, then the nurse asked for specifics on why I was being treated for it and i admitted that I had been an IV opiod addict for several years, At my Doctors appointment a few weeks later he had told me that he could no longer be my doctor because it was obvious i did not want help since it was brought to his attention that I had been abusing my medicine by injecting it. Knowing I had not been abusing it I went to my family doctor who then diagnosed me with raynauds disease... Which is completely unrelated to any previous addiction problems, and told me he had received a digital file from the hospital claiming i am a drug addict. However it is to late for my records to be ammended because I made the mistake of telling a hospital nurse that in my past i had a problem, and she put it on a digital filing network. however if someone were to tell a psychiatrist or a substance abuse doctor that they were injecting crack and ajax he could not put it in them records. So as long as it is not an addiction doctor or mental health then yes they can put it in a file and share the information, marking your father as an addict, and possible getting him cut off from his much needed medication. It is tragic the stigma that goes with pain patients.
 
I'll try to make a long story short, but it is really frustrating for me, so sorry if I ramble any.
We had a family doctor for a couple of years and then lost Medicaid. The cost was far too much and so I turned to the local community health center, which offers an income-based reduced fee for care. For almost two years, the doctor there was my primary. When we got Medicaid back, I began seeing the old doctor again. From time to time, about every six months, the community health doc would call to schedule me for a "maintenance appointment." He automatically refilled my meds on chart, which included low dose (5 mg) valium for anxiety. So here I had two doctors prescribing me valium. My primary, who I was using medicaid to see, felt that her prescription of 10 "just in case" pills was more than enough to last me the two to three months between appointments. It was not, and so I willingly allowed the other doc to refill my valium. Apparently, Medicaid saw this as "doctor shopping" or something and informed both doctors. Shortly before that happened, I should note, I began seeing a therapist for my anxiety and depression. The Medicaid primary had a visit scheduled with me, and told me at this appointment that she was troubled by the fact that I was seeing both and receiving valium from both, and that she would like to discontinue my care, allowing me to simply go on seeing the other doc. Not what I wanted and I explained that to her, but that was that. Come to find out, her final diagnosis placed in my permanent medical records? "Drug abuse."
My other doctor disagreed with that diagnosis and my therapist disagreed as well. My therapist took over the dispensing of my therapeutic meds, eliminating the problem. But now, the Medicaid doc refuses to see me, speak to me, or anything to give me the opportunity to discuss her misdiagnosis!! I am so upset I don't know what to do! Seek legal counsel? Let it go?? Will this follow me? And WHY can't I get them to remove it from my records when it wasn't even a proper diagnosis?!?!
 
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