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The legalities of doctor shopping for prescription drugs

The legalities of doctor shopping for prescription drugs

The article below is part of an educational series to help the community better understand Behavioral Health Services (BHS) available to them in Gillette, Wyoming.

I have written before about controlled prescription drugs and that there are some people who seek these drugs, and make it harder for those who need them to receive the help they want. Often, those who are simply seeking medication to address their condition simply want to have a pill to fix a problem regardless of the drugs actual medical use.

When people seek prescription drugs, they often look to have several sources, or doctors, where they have/can receive these drugs. Healthcare facilities call this doctor shopping, and it is illegal. People can go to jail for doctor shopping if convicted. You, as a consumer, should be aware of this.

When Michael Jackson died from a prescription drug overdose, the federal government focused on physicians who have tight ties with celebrities. That was somewhat of a game changer especially when Jackson’s physician went to prison. When Prince, died the federal government started looking harder at all physicians—their respective prescription patterns and the drugs they prescribed. Of course, there have been other celebrities die from prescription drug overdoses, but these two really set the course for the foreseeable future where drug abuse is concerned.

Campbell County Health has a physician working at Behavioral Health Services at Campbell County Memorial Hospital who has worked on criminal cases where a physician was actually arrested for drug distribution and not writing prescriptions for an actual medical condition. Psychiatrist Dr. Mark Walter has provided some insight on this:

Psychiatrist Dr. Mark Walter CCH Behavioral Health Services“From the position of the prescribing provider, distribution of a drug is defined as issuance of a controlled substance prescription without a legitimate medical purpose. From a legal perspective, distribution could occur with one improperly issued prescription; however, law enforcement generally gets involved after a pattern of mis-prescribing emerges in the community—for example, when the physician’s name repeatedly shows up on the patient drug monitoring profiles of arrestees, or after a sentinel event such as a patient death from a prescription drug overdose.

An expert witness is often contracted to review the charts obtained legally. This expert will examine the:

  • indications, or lack thereof, for controlled substance prescriptions
  • amount (both the drug burden and the dosage units) of controlled substances issued
  • provider’s response to indicators of drug abuse and/or diversion
  • appropriateness of the medical workup for conditions that are purported to require controlled substance medications
  • the appropriateness of the duration of therapy
  • as well as other indicators of adherence to the medical standard of care.

This information helps form an opinion about whether specific acts of controlled substance prescribing represent drug distribution according to the Controlled Substances Act of the U.S. Food and Drug Administration. If the expert reaches the opinion that distribution has occurred, that opinion, along with the findings of federal criminal investigators, is generally presented to a federal grand jury.

If an indictment is forthcoming, the provider’s medical board is typically involved, and an action against the prescriber’s license is almost certain. The criminal penalties for drug distribution are severe, and can be subject to sentencing enhancement if deaths are connected to the mis-prescribing.”

Campbell County Health has the right to terminate care to anyone we feel is shopping for drugs, as opposed to actually wanting help with a mental health issue. Physicians/providers are not required to prescribe anything they feel is not in the best interest of the patient’s condition. We want patients that have an interest in getting better. We want patients who listen, are invested and follow through with their respective care.

Jeff Rice is the director of Behavioral Health Services at Campbell County Memorial Hospital. BHS provides professional mental health and substance abuse services to the community through prevention, education, advocacy and treatment for all ages in the community. Appointments are available Monday–Friday from 8 am–5 pm. Call 307.688.5000. Learn more at www.cchwyo.org/BHS.