Doctor Shopping Laws
By FindLaw Staff | Legally reviewed by Aviana Cooper, Esq. | Last reviewed June 27, 2023
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A patient who visits different doctors to get large quantities of a drug is doctor shopping. This practice is, in part, responsible for the U.S. opioid epidemic. The epidemic started with prescription painkillers such as oxycontin. It continues with illegal synthetic opioids. Prescription fraud is one way people fuel their addictions to opioid painkillers. Often patients lie to healthcare providers about their symptoms to secure prescription medication. In other words, they doctor shop.
Doctor shopping occurs when a patient withholds information, falsifies symptoms, or otherwise engages in fraud to get prescriptions for controlled substances. Doctor shopping is a crime under federal and state laws.
This article explores controlled substances and doctor shopping laws in general. It also provides examples of federal and state doctor-shopping laws and common punishments.
Understanding Controlled Substances
The Controlled Substances Act of 1970 regulates controlled substances. It regulates the manufacture, distribution, and use of controlled substances. It has three purposes:
- Combining all federal drug laws before 1970
- Giving the federal government law enforcement power over certain drugs
- Providing a legal foundation in the war against drugs
There are five categories of controlled substances based on their risk for abuse. Prescription drug abuse includes not using a drug as prescribed. It also includes using a friend's opioid prescription.
Types of Controlled Substances
Pain medication is not the only type of a controlled substance. Controlled substances include, but are not limited to:
- Benzodiazepines (Xanax and Valium)
- Painkillers (Oxycodone, Morphine, and Vicodin)
- Non-narcotics (Ketamine)
- Stimulants (Adderall and Ritalin)
A complete list of the current controlled substances is here.
Doctor Shopping: Overview
Doctor shopping involves deception to get prescription drugs for illicit use or sale. Patients fake symptoms, withhold important information, and use other tactics to gain access to their drug of choice. Sometimes doctors are in on the scam, using "pill mills" and selling to addicts and dealers.
Prescription Drug Monitoring Programs
Because doctor shopping involves deception, it's unclear how widespread the problem is.
Interventions like prescription drug monitoring programs (PDMPs) help providers and pharmacists with patients' prescription records. PDMPs are electronic systems that watch and track prescriptions of controlled substances. Providers and pharmacists can check how often a patient receives certain prescriptions. This limits the number of prescription drugs one patient has at one time. It may have an impact on prescription drug overdoses.
Federal Doctor Shopping Law
It is a federal crime to "knowingly or intentionally ... possess a controlled substance" unless obtained through a valid prescription. Under the code, the attempt or conspiracy to get controlled substances is a criminal offense.
Individual states can prosecute drug crimes. All states and the District of Columbia have laws prohibiting doctor shopping.
State Doctor Shopping Laws
Every state has a version of the anti-fraud provision in the Controlled Substances Act. Most states prohibit the willful withholding of information about recent prescriptions for controlled substances.
Examples of state doctor shopping laws include the following:
- Arizona — Communication between a patient and healthcare provider in a fraudulent attempt to get controlled substances is not privileged communication.
- Kansas — It is unlawful for a patient to provide false information "with the intent to deceive" a provider to get prescription medication.
- Montana — Patients are prohibited from getting "the same or a similar dangerous drug ... from another source within the prior 30 days."
- Louisiana — Patients must disclose any controlled substance prescribed within the past 30 days. This includes the amount prescribed and the number of refills.
- Rhode Island — The state has two laws prohibiting such acts. They include acts committed "by fraud, deceit, misrepresentation, or subterfuge." They also include those committed "by the concealment of a material fact."
Penalties for Doctor Shopping Offenses
Penalties for doctor-shoppers vary from state to state. Penalties also depend on the case. Some first-time offenders with substance abuse issues can sometimes avoid prison. In some cases, they can attend drug treatment programs. This is one example of a diversion program for first-time drug offenders.
Otherwise, most convictions, because it is a felony, result in prison time and steep fines.
Get Help
Prescription fraud is a serious crime. If you have concerns, speak to an experienced local criminal defense attorney today.
Can I Solve This on My Own or Do I Need an Attorney?
- Medicare and Medicaid issues can often be handled on your own
- Attorneys are helpful when the health care system is complex
- Complex heath care cases (such as medical malpractice, bioethics, or health advocacy) may need the support of an attorney
Protect your patient rights with an attorney at your side. An attorney can offer tailored advice and help prevent common mistakes.
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