Who is to Blame for Doctor Shopping?
Prescription drug abuse is out of control, and it now accounts for more deaths than cocaine and heroin combined, but who is to blame? Should we accuse the doctors for making it too easy for people to get hold of these substances? Or is it the fault of patients who are often so desperate that they will try every trick in the book to get their hands on a prescription?
The shocking death of Michael Jackson, which was five years ago this week, sparked a huge debate on the availability of prescription drugs. His autopsy determined that a deadly mix of four strong sedatives triggered a cardiac arrest – these drugs had been prescribed for him by his personal physician. The coroner concluded, “This cocktail was a recipe for disaster”. There was outcry as to how something like this could happen, but what lessons have we learned from this tragedy?
There is no doubt doctors must take some responsibility for the prescription drug epidemic. A court in the US found Dr Conrad Murray guilty of the manslaughter of Michael Jackson, and he was given a four-year jail sentence. The evidence suggests he allowed the star to be using enough sedatives to put an army to sleep. There are doctors out there who are too willing to prescribe dangerous medications, this needs to change, but there are also patients who seek these physicians out.
Doctor Shopping Is Driving the Prescription Drug Epidemic
The term Doctor Shopping refers to a patient visiting more than one doctor to collect medication for recreational use.
It wasn’t until after I cleaned up from heroin ten years ago that I first came across the term ‘doctor shopping’. This activity would be frequently mentioned by clients in the rehabs where I worked. These were often people who looked upon the act of going to a drug dealer as a bit of a taboo, yet they had no qualms about using doctors to satisfy their addiction. Prescribed medication can certainly seem more legit, but these substances can be more dangerous than street drugs.
A recent study, conducted by researchers at McGill University in the US, found prescribed painkiller medication to be responsible for more deaths than cocaine and heroin combined. The number of fatalities in America from narcotic overdoses has tripled in the last decade, and there is no sign that this trend is changing any time soon. The idea that prescription medications are somehow safer than street drugs is just wrong.
As an insider working closely with doctors, I can tell you there is often a conflict when it comes to prescribing medication to addicts. These are people with a habit to maintain, and they know how to use the system to do it.
Doctors Can Feel Pressurised into Prescribing Drugs
Addicts can be extremely manipulative. The doctor may be afraid to say ‘no’ because of the fear of being accused of ignoring symptoms or losing a private patient. Emotional blackmail can be used along with blatant dishonesty, suicide threats, and even intimidation.
I have personally witnessed a client screaming and rolling around on the ground as if she were dying and demanding Fentanyl – this drug is 50 times stronger than morphine and normally only used after surgery. The doctors had investigated her claims, but test after test found nothing physically wrong with her.
Another client told me how she stole mum’s morphine which had been prescribed to manage pain due to cancer. After her mother died, she demanded that the doctor continue prescribing the drugs with threats that she would ‘sell herself’ to buy street drugs if he didn’t. He continued writing prescriptions for another ten years.
Last month we had a 30 year old man check in from Australia, and his medication bag was bigger than his luggage. Thankfully, within 2 weeks, he was able to come off the majority of these drugs, but in my opinion, none of them were necessary.
More needs to be done to shed light on what is often a hidden problem. This is why we can be thankful to people like Cat Marnell, a recent client of our rehab, who is willing to be open about her previous addiction to Xanax and Adderall.
Our clients understand that they need to take responsibility for their addiction problems because this is the only way forward.
Should We Blame Those Who Doctor Shop?
Most people don’t set out to become hooked on prescription drugs. No matter how or why the narcotic medications are acquired, they are highly addictive, and the user can easily form a tolerance and dependency in a short period of time.
The problem is that while this medication can bring relief to the diagnosed problem initially, there are risks involved in prolonged usage. If the underlying causes of the symptoms are not properly addressed, it means that over time, the patient will face the same addiction issues that all addicts face.
Another problem is that in too many cases, these addictive substances should never have been prescribed in the first place. This can happen if there has been a misdiagnosis because the doctor failed to pick up on the signs of substance abuse or mental illness. There is also the reality that some doctors seem only too willing to provide a chemical solution for issues of anxiety or depression rather than address the underlying issues.
Prescription Drug Abuse is a Complex Issue
So back the earlier question, what have we learned in the five years since the death of Michael Jackson? Well, we know it is not as simple as just blaming doctors or those who have usually unwittingly developed an addiction. This is a complex issue, and it is going to need to be dealt with from multiple angles.
One of my clients summed the situation up well with this quote:
“Treatment had to break my pattern for blaming others for my addiction, so it is hard for me to focus on the doctor’s fault. But, as I look at the list of medications I was on, I have to believe I had a part and so did they.”
At the Hope Rehab Centre here in Thailand, we are increasingly working with clients who have suffered greatly due to prescription drug addiction. We provide a sanctuary where these people can regain control over their lives.
Who is to Blame for Doctor Shopping? By Simon M
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