Doctor Shopping: How the Medical Community Can Stop It

Medical leaders from local health care systems met today to discuss how to prevent “doctor shopping” and other strategies to keep prescription drugs from getting in the wrong hands.

At a conference hosted by Kaiser Permanente, the San Diego County Medical Society and the San Diego County Prescription Drug Abuse Task Force, participants discussed how to prevent drug abusers from going from doctor to doctor and to local emergency rooms to get prescription drugs, especially painkillers, fraudulently. They also addressed how to get more doctors and pharmacists to use a database designed to prevent the diversion of prescription medications.

The event shared information on the following tools that have been shown to curb prescription drug abuse:

  • Doctor-Patient Agreements: Formal agreements to deter “doctor shopping,” the practice of visiting multiple doctors to obtain prescription drugs. Patients are asked to sign the agreement, which informs them of dangers of drug misuse, explains that there are special laws doctors and patients must follow regarding certain prescription medications and asks the patient to pledge to use the medications as instructed and not sell or let others take them.
  • Safe-Prescribing Guidelines: Prevent drug abusers from obtaining prescription drugs from emergency rooms through fraudulent means. The guidelines, developed in San Diego County, are now being used statewide.
  • The CURES Database:  Tracks patients and prescriptions and helps doctors, pharmacists and law enforcement to detect the improper diversion of medications.

“When medical professionals use these tools, they ensure patients get the medications they need and curb the illegal diversion of medications,” said Dr. Roneet Lev, director of operations for Scripps Mercy Hospital San Diego and chair of the San Diego County Prescription Drug Abuse Medical Task Force. “Our local medical community should be sending a unified message: One provider, one pharmacy for all controlled substances.”

The diversion of medications for recreational drug abuse is fueling what the U.S. Centers for Disease Control and Prevention has declared “a nationwide prescription drug epidemic.”

Today, opiate-related overdoses are the leading cause of accidental death in San Diego County and throughout the United States, exceeding even car-crash deaths. Locally, there were 259 prescription-related deaths in in San Diego County in 2013, compared to 247 vehicle fatalaties.Locally, 1,260 people died from prescription drug abuse from 2008 through 2013, according to the San Diego County Medical Examiner’s Office.

Furthermore, prescription drug misuse continues to fuel abuse of heroin, a much cheaper alternative. In 2013, nearly 25 percent of people entering treatment did so because of heroin abuse and 86 heroin deaths were reported.

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“Preventing doctor shopping and fraudulent use of local emergency rooms are critical strategies to prevent prescription drug abuse and help San Diego County residents be safe,” said Wilma Wooten, M.D., M.P.H., County public health officer. “Prescription drug abuse is increasing heroin use and that is very troubling. Treatment is available.”

Medical providers can register for the CURES database completely free at the County Health and Human Services Agency Office of Vital Records and Statistics located at 3851 Rosecrans Street. No appointment is necessary.

Parents who believe their child might have a drug problem and adults with substance abuse issues should call the County’s Access and Crisis Line at (888) 724-7240.

José A. Álvarez is a communications specialist with the County of San Diego Communications Office. Contact