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

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ihatepipes

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I am in the U.S. and I was just reading through another thread when I saw a post concerning being labeled as a person who seeks drugs by a medical professional. Is there anybody with experience concerning this topic, and how does the system work? I have heard all different kinds of things and came up with my own ideas about what goes on, but never any concrete information from a healthcare professional/person who has tried to fight being labeled as a drug seeker. I couldn't find any threads concerning this specifically so I apologize if this has already been discussed.
 

RecklessWOT

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I'll leave this open as long as it doesn't turn into a "how can I get my doctor to give me drugs" thread.
I actually wonder about this a little too, even if I have a legitimate problem and actually need medication I never want to make suggestions/ bring it up because I don't want the doctor to think I'm just looking for drugs.
 

Johnny blue

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I think the term is mostly used to describe those that doctor shop or that frequently visit the ER asking for drugs. The average person does not even have to think of this if that's what you mean.
 

cj

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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.
 

Johnny blue

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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.
Not in my experience although your doctor may think twice about prescribing them in the first place. Still though just being on subs doesn't make you a drug seeker. If you have 3 different narcotic scripts for the same drug from 3 different doctors then you could be labelled a drug seeker.
 

Tommyboy

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It depends on the circumstances, as well as the state , since not all of them have the same systems in place for monitoring these things.

Most states now have the prescription monitoring program (PMP), and the link details the status of them in each state. Pharmacists enter each controlled substance a person is prescribed into the database, and that information can be accessed by other pharmacies, doctors, and law enforcement. This prevents people from getting away with doctor shopping by the old method of paying cash and using different pharmacies. Before these monitoring systems were implemented, it was the persons insurance that they had to worry about, so as long as they did not use their insurance for multiple doctors/prescriptions, there was a lesser chance of being caught.

If a person goes to a new doctor for a condition that may require a controlled substance to be prescribed, the doctor can check the PMP database to see your prescribing history (the link above shows how long the data is kept for). Even if he doesn't check it and goes ahead with prescribing you another controlled substance while you are already getting one from another doctor, the PMP will catch on to this.

So what happens then?

In the case of my friend who saw two doctors for the same thing, he received a letter in the mail about it. I don't remember what company/agency sent it though, but the letter came off as them being concerned, instead of saying he was busted (although it did say they notified both prescribing doctors about it). It said that they sent the letter because their records indicated he was seeing multiple doctors, and they notified both him and the doctors in order to prevent him from having any dangerous drug interactions from combinations that he may be taking since both doctors did not know they were both treating him and prescribing him stuff. The letter also said that another reason they send them is to notify the doctors the person is seeing in an attempt to minimize prescription drug abuse and diversion, which as we know is probably the only reason they sent it. It is then up to those doctors to continue treating you or not, but I'm sure that if one of them does, they will be very cautious of what they prescribe you from then on. In the case of my friend the doctors sent him a letter refusing to see him again.

Other than viewing your prescribing history in the PMP, I am not sure if there is any official way for you to be labeled a drug seeker such that any other doctor you see in the future would be notified of this, unless maybe your insurance can do that. I don't think that there is a main "drug seeker" database that would come up with a hit if any doctor were to search the name of someone caught doing this. I could be wrong though, I just haven't heard of such a thing (other than rumors) with a link to support the claim.

Your doctor can take note of it in your patient file at their office, but I don't think that info would be seen by anyone other than the other doctors in that same office/practice that might see you for an appointment. The same would apply to the ER if you keep going there for pain meds and the doctors catch on and put that you are a drug seeker in your file there. I was labeled a drug addict at the doctors office where I had gone to school. The psychiatrist that I was supposed to see cancelled on me twice, any my school was very far away from my psychiatrist at home and I was about to run out of xanax that I was prescribed for a while (psychiatrist from home sent me a script the first time the new psychiatrist cancelled, but did not feel comfortable sending anymore). I made an appointment at the doctors office and told them I needed a xanax prescription because the psychiatrist cancelled on me already, and I had just run out after stretching out the script for a long time. The nurse practitioner that I had the appointment with finally gave in and wrote me a script after verifying that I had been prescribed in for a while, but she felt the need to write in my file that I was an addict. That never left that office AFAIK, but whenever I had an appointment there and a different doctor or NP would see me, they would ask about it when they asked if I was on any medications and I told them diazepam, and they basically just said the other nurse wrote in my chart that I was an addict. It never mattered since I never needed any pain killers or anything while I was in school there, plus the other doctors were understanding that I had been stuck without xanax and I had told the nurse I was dependent on them and she automatically took that as being addicted. I've never had an issue being prescribed any controlled substances needed since then.

"Doctor shoppers" will get caught by prescription monitoring systems, but I don't think that someone that a doctor deems a drug seeker (exaggerates/fakes/lies about pain or anxiety in an attempt to get a prescription) will have any repercussions other than losing that doctors trust and/or them refusing to see you again.
 
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ms4104

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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 have had pharmacists tell me that that was the case..then i said I would pay cash and they were like OK well we have to call your suboxone doctor and verify that it would be ok. I am like its none of your ufckin business but I didn't pursue it to get some shitty vic's when I could go spend a few bucks on a bag of dope that was equal to like 30 of them lol
 
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ihatepipes

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Reckless: That is not what I am getting at at all I understand the rules. That being said I want to know what happens, what goes on your file, if you are in a state with a prescription drug registry are you flagged there as well meaning any doctor can tell you have been labeled as possibly being an addict?

To me this is something of an urban myth if you will. what I mean by that is you hear people talk about it alot but never really find any hard evidence or protocol concerning this being labeled a drug seeker.

EDIT*
Tommyboy saw your post after I made this one thanks for the info!
 

ihatepipes

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I'll leave this open as long as it doesn't turn into a "how can I get my doctor to give me drugs" thread.
I actually wonder about this a little too, even if I have a legitimate problem and actually need medication I never want to make suggestions/ bring it up because I don't want the doctor to think I'm just looking for drugs.
This is really the reason I am asking because my my dad is a PM patient he tells me his medicine is not working as good as it use too (he does not abuse his meds i.e. he swallows them whole always). I say: "you need to talk to your doctor about that because tolerance builds over time" He says: I am scared to talk to him about it because I don't want to risk losing what I am lucky enough to get".

The messed up part about it is that the doctor has really given my dad a reason to be afraid. My dad tried to talk to his dr. awhile ago about his dosage The doctor right tells him he won't up his dosage leaves the room and a MA comes back into the room with a cup for a fucking piss test (my dad does not drink or take any medicines than the ones he is prescribed).

I think that this is a sorry excuse for a doctor patient relationship. A patient should be able to openly talk to their doctor about any medical subject concerning treatment of said patient. DEA has intimidated doctor's to the point where they literally must decide between their medical license and treating their patient with compassion.

I do think drugs should be regulated because people need to be getting info from their PCP on whatever meds are being prescribed (for HR purposes of course). However, opiates should be treated like any other drug. My doctor doesn't flip out on me when I take an extra 50 mgs of quetiapine why should my dads PM doc lose his fucking mind if my dad is in extreme pain and requires an extra tablet 2 or 3 days a month?

It is pretty fucking ridiculous how little a part common sense and rationality play in policy development/implementation in the U.S.A.. The government needs to be put in it's place, the place those old guys who wrote the constitution (as fucked up as some of their personal affairs may have been) intended it to be. Minimal interference and freedom for the people.
 

Johnny blue

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That is a fucked up way to treat a patient for sure. The thing is that some doctors are really just trying to cover their own ass. Its sad but necessary in a time where doctors get sued for every little thing. We get a lot of posters here that complain about not getting the meds that they really need. Many think that it's just the doctor being a douche and sometimes that is probably true but I also think that doctors are a lot more careful about prescribing pain meds because they have to be.

If your father can't get what he needs from this doctor he may want to seek a second opinion.
 

brutus

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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've done it several times but never had any problems, but I live in Georgia and we don't have a prescription monitoring program. A lot of pharmacies here are refusing to sale bupe and that's just fucked up on several levels.
 

Johnny blue

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I've done it several times but never had any problems, but I live in Georgia and we don't have a prescription monitoring program. A lot of pharmacies here are refusing to sale bupe and that's just fucked up on several levels.
Why would they refuse to sell bupe? That is unbelievably fucked up.
 

ms4104

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I have only had private pharmacies turn me down and thats for like 90 2mg pills.. never had a prob with the 8mg. I think if you have insurance the profit is like too small and they just dont give a fuck and dont wanna go thrtough the trouble to order. Duane Reade has no problem handing me over 3 sealed 30 count bottles straight from the warehouse.
 

brutus

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^ I think that is the reason why some places here won't sell bupe. It just seems to be the smaller pharmacy chains and even the mom and pop style that won't carry it. The pharmacist told me that there was too much paperwork associated with having to fill bupe scripts and even more requirements were supposed to come out in 2012. But my bupe doctor said the same thing verbatim. I never really checked into what he said about all the requirements because I figured he was exaggerating.

I do live in a rural area, but there are plenty of bupe patients so the demand is here. My pharmacy didn't have an issue with it about 4 years ago, but the pharmacist didn't even know what Suboxone was used for. Plus I figure that maybe the smaller pharmacies look at it like selling the morning after pill to young girls or even needles to suspected IV drug users. I know the later is against the law in the majority of states, but still it is apples and oranges to selling bupe. If ethical reasons are behind some places not selling bupe then that's some fucked up shit. It would be like refusing to sell insulin to a diabetic because you think that the diabetic should do something else about diabetes instead of using insulin.
 

ONandOFF777

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I think it is more or less an urban myth as you stated because even in states with PMP HIPPA still applies.

On a small scale like within a specific doctors office or hospital you can be labeled or flagged but there is not a federal or really even any state wide system to label any one like that because access to that info would be restricted by HIPPA.

Most likely your friend got a letter from the pharmacy as the state wide PMP showed them that he was getting prescribed meds that are flagged in that database
 

Coraline

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If you see a dr you have a medical record. Everything from a cold to a bladder infection has a ICD-9 code. These codes are for diagnosing conditions. Each number means a different thing. Drug seeker and people who use any substance and it is found in system via urine, hair, blood or by word of mouth will have a IDC-9 code for that substance in their file. It does not go away. If you file insurance it will be in your record there. If you are in a hospital it is in that system. Once you are labeled it is kinda hard to escape it. Most physicians will ask for past records and if you do not let them that throws up major red flags. There is a record for each of us and past medical history can be hard to escape. When patients become demanding yelling be really inappropriate when it's not even time for more medication and there is no organic cause for the pain, thats when people take a closer look at them. This is how they get labeled.
 

Tommyboy

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^ I think those codes are more for billing purposes.

I have never been to a physician that asked for past records. They just had me fill out the standard documents where you check off and conditions or symptoms you have experienced. If our medical records were hard to escape, then I doubt I would be getting the meds I am now.
 

Coraline

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This is my experience in long term care/ physical rehab facilities. I also have seen it in the home health setting. If you look in the charts on the face sheet/ 485 you will see all the diagnoses with the IDC-9 code that you have received with the date. There is a data base with your medical history. I'm not sure exactly how it works but it is there.
 

ONandOFF777

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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!!!!!
 
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