I'm starting this thread in case there is anyone interested in the question of laws that might apply to double-dipping. The question on this came up in the RxByPhone thread under Q&A, and since the matter was off topic there I thought I would start a new thread on it here.



Since the statements in that thread are rather ominous sounding, stating that double dipping can be a felony and/or a federal offense, I thought I'd begin this thread by posting the basic information I have found and leave it to anyone with better knowledge on the subject to add to or correct what I have posted.



First, here's a quote from a news article that gives a pretty clear definition of what double dipping actually is:



"According to the Hawaii Revised Statutes, it is a felony for a patient to intentionally visit more than one physician and withhold information regarding previous doctor visits for the purpose of obtaining controlled substances."



The question was raised in the previous thread as to whether this "crime" is something monitored and/or regulated on a federal level, or on a state level. I searched the US criminal code and couldn't find any reference to it there. Here is another quote I posted in that thread that seems to be an indication, on good authority, that monitoring is done on a state level.... it's a quote from Asa Hutchinson, the "drug czar," to a meeting of the American Pain Society:



"We're encouraging the development of state prescription monitoring programs. We have found that states that have these programs in place have the lowest numbers of diversion problems."



A prescription monitoring program is a system by which the government keeps track of who is getting prescriptions for which controlled substances, and how often they get them. The quote from the above news story from Hawaii vaguely refers to "controlled substances," but when I checked the law of a state that does have such a program in place, Illinois, it clearly limited the controlled substances that were to be monitored to Schedule II drugs only, which would not apply to U.S. OPs -- no US online physician or pharmacy prescribes or dispenses any Schedule II drug to OP patients. Here is the statute from Illinois for the prescription monitoring program:



(720 ILCS 570/316) Sec. 316. Schedule II controlled substance prescription monitoring program.



The Department must provide for a Schedule II controlled substance prescription monitoring program that includes the following components:



(1) Each time a Schedule II controlled substance is dispensed, the dispenser must transmit to the central repository the following information:

(A) The recipient's name.

(B) The recipient's address.

(C) The national drug code number of the Schedule II controlled substance dispensed.

(D) The date the Schedule II controlled substance is dispensed.

(E) The quantity of the Schedule II controlled substance dispensed.

(F) The dispenser's United States drug Enforcement Agency registration number.

(G) The prescriber's United States drug Enforcement Agency registration number.

(2) The information required to be transmitted under this Section must be transmitted not more than 15 days after the date on which a Schedule II controlled substance is dispensed.

(3) A dispenser must transmit the information required under this Section by:

(A) an electronic device compatible with the receiving device of the central repository;

(B) a computer diskette;

(C) a magnetic tape; or

(D) a pharmacy universal claim form or Pharmacy Inventory Control form; that meets specifications prescribed by the Department. Schedule II controlled substance prescription monitoring does not apply to Schedule II controlled substance prescriptions as exempted under Section 313.

(Source: P.A. 91-576, eff. 4-1-00; 91-714, eff. 6-2-00.)



(end of citation)



This regulation makes no reference to Schedule III drugs, and even exempts some Schedule II drugs from monitoring.



The following section seems to be the place where any laws about double dipping would appear, since it covers giving false or fraudulent information to obtain controlled drugs (Paragraphs 3 and 4).



(b) It is unlawful for any person knowingly:

(1) to distribute, as a registrant, a controlled substance classified in Schedule I or II, except pursuant to an order form as required by Section 307 of this Act; or

(2) to use, in the course of the manufacture or distribution of a controlled substance, a registration number which is fictitious, revoked, suspended, or issued to another person; or

(3) to acquire or obtain possession of a controlled substance by misrepresentation, fraud, forgery, deception or subterfuge; or

(4) to furnish false or fraudulent material information in, or omit any material information from, any application, report or other document required to be kept or filed under this Act, or any record required to be kept by this Act; or

(5) to make, distribute or possess any punch, die, plate, stone or other thing designed to print, imprint or reproduce the trademark, trade name or other identifying mark, imprint or device of another, or any likeness of any of the foregoing, upon any controlled substance or container or labeling thereof so as to render the drug a counterfeit substance; or

(6) to possess without authorization, blank prescription forms or counterfeit prescription forms; or

(7) (Blank).

Any person who violates this subsection (b) is guilty of a Class 4 felony for the first offense and a Class 3 felony for each subsequent offense. The fine for the first offense shall be not more than $100,000. The fine for each subsequent offense shall not be more than $200,000. (c) A person who knowingly or intentionally violates Section 316, 317, 318, or 319 is guilty of a Class A misdemeanor. (Source: P.A. 91-576, eff. 4-1-00.)



(end of citation)



When I checked the criminal code of my own state, there was no reference to a prescription monitoring program at all, it only contained language almost identical to the second section above from Illinois, regarding providing false/misleading information to obtain a controlled substance.



My understanding is that the prescription monitoring programs are intended to cut down on the diversion of controlled substances, which primarily refers to the misuse of controlled drugs and/or the resale of controlled drugs on the "black market." It's common knowledge that some Schedule II drugs sell on the street for $60 or more per dose, making it potentially very big business. My understanding is that this is the activity the laws are aimed at stopping, rather than to arrest and criminally charge pain patients who switch doctors and as a result, their prescriptions overlap.



Anyone concerned about these laws can check the laws of their own state online. Here is a link to a searchable database of state laws, and there are many others out there as well.



http://www.law.cornell.edu/topics/state_statutes2.html

We need to distinguish between electronic prescription monitoring (EPM) programs (such as those of HI) and laws against double-dipping. EPMs apply only to C-IIs. They're in place in fewer than half the states. A pharmacist or doctor can tap in to the system to see if a particular patient is receiving a C-II before issuing a new prescription. The patient's privacy rights for that are waived by the state law.



As i stated elsewhere, not every state requires a patient to disclose controlled substance prescriptions from another practitioner ... unless they are asked (see below).



OTOH. Probably every state makes it a crime to use false information or conceal a material fact to obtain controlled substances. If the doctor hands you a form asking you to state your current medications and you leave out a controlled substance you're receiving from someone else ... well, that's concealment of a material fact. But in my state there's no law that requires a doctor to ask, and no law that requires a patient to tell if they're not asked.



Of course, a jury here could decide that keeping your mouth shut was tantamount to concealment of a material fact and convict you anyway ... even if the doctor didn't ask.



Thanks for proving out that these laws vary widely by state.

Thanks Trampy, so double dipping can be a chargeable offense where C-III medication is concerned, in some states, if the patient doesn't disclose previous (and I would assume, still current) prescriptions to a new doctor or OP. If I understand this correctly, since there isn't a monitoring program that specifically tracks C-III medications, any discovery of multiple prescriptions for a particular patient would only happen, it seems, as a result of some kind of investigation into that patient's prescription records, meaning that there would have to be some specific reason for a particular patient to be singled out for investigation, whereas with C-II drugs, the identifying of patients with multiple prescriptions is done automatically.



Another thing I wasn't sure about is whether it is the laws of the state the patient is in or the state the OP is in that would apply in such situations.

Yes, getting multiple scrips for C-IIIs could be a chargeable offense .... even if it's just for personal use and your own state has no "doctor shopping" law per se .... if it involves any concealment of a material fact. But every time i've ever seen a doctor (or dentist) in person they have always asked me (verbally or on a form) what meds i'm currently taking and (sometimes) who prescribed them. It's not a crime (here) to leave out an antibiotic or an unscheduled anticonvulsant (for example), but if i went to a doctor to get a C-III PK and i didn't put down on the form that i was getting other controlled sub PKs from another doctor (located anywhere), well that's probably concealment of a material fact, and so it'd be a Class IV (the lowest) felony here if there are no prior drug convictions.

As far as the governing state law for OPs. The pharmacy and doctor is responsible for following the laws of their state. But if you're located in a different state, then you're responsible for following your own state's laws and you can be prosecuted by your own state if you fail to do so. In my case, when i used an OP in another state i filled out the form and gave them 100% correct information. So i wasn't breaking any laws, and it's not the patient's problem if the doctor spent only two minutes on the phone and asked only about drug allergies.

If a state has laws that require you to disclose all current scrips for controlled subs and you fail to tell a doctor in another state, then you're breaking your own state's laws. Your own state's laws apply to what you do in that state. Since you're calling from there, that state's laws apply.

www.findlaw.com is another place to look up your own state's laws. Sometimes the best source of information about how they actually enforce the law is to find the statutes first and then read the state appeals court cases. You can find them under State Cases and Codes at www.findlaw.com . Many states have put all their appeals cases on-line and you can search by keyword or statute #. They tell the real story.

Thanks for the good information, this was all news to me. It would certainly be a shame for someone who didn't know better to get into trouble simply because they didn't realize that it was illegal to have prescriptions that were partially concurrent. It would be interesting to check the case law to see just how extreme some of the prosecutions have been, as in the case of minor lapses in which people just didn't know better.

Just want to say thanks to both Phiniky44 and Trampy for such useful info. You've certainly done your research. I will make good use of it too!
Paula

And most online OP's, whether in a different state or not (usually they are and refuse to sell to residents of their own state) ask you to fill out a form before the consult and the question of current meds comes up. Like Trampy, in this part I was completely honest with the OP, told them I had a prescription for the med I was ordering, but it was going to run out soon and needed to replace it quickly. Literally, that would be double-dipping since I already had an active prescription for pain killers from my doctor, though it was due to expire within a few days.

The OP didn't have a problem with this because I told them the whole story. However, many OPs, I can't speak for all of them, make you click off a disclaimer at the end in which you agree that all the information you have given is true and correct. So it would be lying to not mention any meds in that form, and would be double dipping due to concealed materials? The OP is a doctor and they do ask.

Yes, "concealment of a material fact" or a false statement made in order to obtain controlled substances from a physician or pharmacist is a felony in most states. But if you have a prescription that runs out in a few days and no refills, i doubt it'd be considered a material fact.

Bump

Too good to let drop!

The first link below is the language of an actual "doctor shopping" law, which not many states have on the books (this one from Hawaii). Most of them just have the generalized rule about not giving false information to obtain drugs. The language of the laws are often very similar in the various states, so a section of text from this law can be used to search the database of statutes in any state, and will probably turn up a similar law if one exists. It might be good to have a list of states that have these laws and if anyone finds such a law in their state, perhaps a list could be developed for future reference.



Also, Hawaii has an unusually strict monitoring program that does not limit monitoring to C-II drugs, but can be used to monitor any drug the state agencies feel is being abused. That link is beneath the doctor shopping law. I saw a question on the board recently about "shared databases" that track the prescribing info on individual patients. I don't know if this is the same thing or not.



Doctor Shopping law:



http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch321-344/hrs329/HRS_329-46.htm



Monitoring Program:



http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch321-344/hrs329/HRS_329-101.htm

Hi to all, I just got out of the hospital a couple days ago. I told the doc that I was getting oxycontin from my family doc. He discussed me getting off them but I don't want to suffer any longer than I have already. On discharge he prescribed me vicoden (one week supply) Now I don't want to red flag myself here so was wondering, do I have to tell my family doc about the weeks script? Also another ? Do pharmacies communicate with each other Like walgreens to rite aid? Is there a computer data source to find info on folks? Or access in some way with pharmacy info and doc and other pharmacy (of course DEA knows all) Oh, and one more thing, can my insurance tell anyone about my meds or dr visits without my consent? I know I sound like I'm trying to get away with something here but mainly I am concerned about my privacy. I also know how strict the DEA and others are concerning oxys and pain meds in general. BTW my pain source (back) is all well documented. I have pain daily even with oxy. I would hate to jepardize my script because they have given me back my life. Sorry so long. Take care Love Saintlady

With all the other troubles going down in our society, i have to wonder about the goverment or state's time and expense used on searching out individuals who may have a problem with pain meds......unless you are talking about gun carrying thugs, then I think it is a waste of time and funds (our tax $$$$ folks) in tyring to "cure" all pain med abusers. What about alcohol? No one is going after the alcoholic unless they are behind the wheel of a car or in a position to harm others by their "alcohol" abuse.
Just a thought.
Shawn

Avoid the problem and tell your other doctor.



Or do not use insurance and do use another pharmacy that doesn't accept the insurance plan you have. JMO I could be wrong. Otherwise your current pharmacy may look at you cross-eyed... If ya just tell your usual doc...it'd avoid any possible problems. Especially if you live in Nevada!

It almost depends on your local state law on what you have to say and do...to stay legit.



Edited to add: If you just got out of the hospital...describe it as prescribed for breakthrough pain if that is your understanding...won't one doc give the other one a report anyway?

On the insurance issue: If you go to two different pharmacies for the same medication, your insurance company will not pay for the script at the second pharmacy. This could also start a chain of events, such as the second pharmacy calling your insurance company to find out why they rejected the payment. Then, the insurance company tells the second pharmacy that you just filled a script for the same medication at pharmacy #1. Then the second pharmacy calls pharmacy #1 and you get the picture.

That's why I suggest to not use insurance...but the usual pharmacy patronized already has that info and will run the script thru the ins., so it is best to avoid that by paying cash somewhere else,imo.
MonsterMash...is correct...can we all see digital trails...?

From a google search State monitoring

Lumbar,

GREAT information! 5 Stars!!!

This can help everybody that is a member at this site. I had no ideas some states tracked CIV's and CV's

That is a great site LS! Thank god my state isn't wasting taxpayer dollars YET on this stupid issue. Once we get the schools fixed, decent housing, etc. etc., then the government can waste my money figuring out how many pills we're all getting. You also make an excellent point about insurance. One of the easiest ways to get nailed "double dipping" is to submit the scripts for insurance to pay. Cash, as usual is King.

OK, here's a question....... after I got my records from my Dr. and saw the notations of scripts I had filled at other pharmacies, I decided to go to a different Dr. for a new problem that came up. I chose to use another Dr. because I was not too happy with what I found that they had written in my records and want nothing more to do with that particular Dr. anymore.

When the (new) Dr. came in he said, "I just want to let u know that Dr. XXX's office called me about some scripts u received from them." I replied, "Yes, I did use that Dr. for a neck problem and was treated with Hydrocodone (Vikes.)" The (new) Dr. then said to me, "I just want you and I to be on the same page so that the DEA does not need to get involved." WHAT THE?!!!

So, after my appt, I went back to my original Dr. and asked to speak with the office manager. Of course, she is not in until tomorrow. I said I had a question / problem with them calling another Dr. in the area and discussing me and my previous medications. I then said I wanted a copy of my entire medical file including any notes of calls made to other healthcare providers.

On the wall of this Dr.'s office is a sign that states "We will not disclose your record to others unless you direct us to do so or unless the law authorizes or compels us to do so."

I said i wanted a copy of that particular law because I certainly did NOT authorize anyone at that office to (out of the blue) contact another Dr.'s office in the area to "discuss me."

I am mad as heck over this......any advice? Does this not fall under "Dr. / Patient confidentiality"? Help please, advise needed!!!!!

get your records and find out what is in them. I have a feeling there is more to this.

I live in Georgia and here is my story. I have been seeing an orthapeodic surgeon for my lower back pain and he prescribed 50 5/500 vicodins to take 1 or 2 every 4 hours.I had this filled at a mom/pop on my insuarnce.A week later I had surgery on my hand and that doctor prescribed 30 lortabs for the pain. I took it to the hospital pharmacy and asked to pay put of pocket. When I came back to pick it up the pharmacist pulled me to the side and asked if I knew what double dipping was. I played along with it and asked what the problem was.She informed that I had the same medicine Rx filled a week prior and that she could not allow me to fill the new script. I explained to her that I take the hydro for my back and that I would be out in a week if I was expected to use my back meds for my hand as well. She gave the script back to me and told me to take it up with my doctors as her pharmacy would not feel comfortable filling it.Anyways I called the doctor and he told me to just wait another week and fill it and he would vouch for the script being valid even tho it will be 3 weeks old.It appears to me that there is some sort of database allready in place here in Georgia.

I just gotta say, that gives me the creeps. That's just downright frightening and I can just hear him telling you that. I remember when that happenend to me before I knew any better. I went to get a small script for vicodin filled at an Osco Drugstore after leaving the ER. I had gotten one filled a week earlier at a different Osco and was so amazed when they wouldn't fill it. Well I realize now how it works but didn't at the time. A Walgreens down the street filled it because they use their own data base but I'm amazed they did fill it because Osco wrote all over it "too soon" or something similar to that. I recently had a pharmacist at a Walgreens refuse to give me the 2nd of 3 refills I had for Norco because THEY didn't feel I should be taking that amount (4/day every ten days)--as written by the doctor. They were gonna call my doctor first to let them know they thought he had prescribed too much!! I waited until the morning and reordered the refill online and it went thru without a problem. Evidently this idiot hadn't made a note of it in the computer. Anything like that happen to anyone else? I wasn't getting the refill too early or anything like that. She for no reason wanted to question the doctor. I think that's pretty nervy

I live in Georgia also, but I don't think that there is a monitoring program in this state. Did the hospital have your insurance information? They could have run it through on your insurance and it came up in this manner.

Insurance is a web of information made accessible and plain to read by all who have access to the information.

I had the exact smae thing happen to me at Walgreens too! I had a script for Vicoden 5/500 30 tabs, taking 2 every 6 hours. I also had two refills. I had the original script filled on a tuesday, I went in on Saturday to get my refill. Now 6 pills a day for 5 days equals 30 dosen't it?
When I asked for my refill, they also told me it was too early. I told them that I was not taking too musch, I was taking the amount prescribed on the label. 30 pills would last 5 days. They said I would have to wait 14 days to get my refill. I was mad and panicked that I would run out. When I got home, I went online and requested a refill that way at another Walgreens store. I got it filled on Sunday with no problems. Now why did he fill it with no problems or comments, while the other pharmacist wouldn't? I think that it depends who you go to. I think that they are using their own judgement system with narcotic meds. I mean, thats why we got refills on our meds. Our doctors felt that we could be trusted with narcotics, they were comfortable giving them to us, so why should the pharmacist not be? I am sick and tired of all of this. Ever since I have been diagnosed with chronic pain, I have had nothing but trouble at doctors offices and pharmacies. Its making me want to use OP's exclusively.

Pharmacists have a lot of discretion in deciding when to give out refills. But if you're using insurance, then the insurance company can make up Rules the pharmacist has to follow on how long to wait. But if you pay it yourself, then it's all up to the pharmacist and the law. In most states, if you have a scrip for a C-III through C-V that says 5 refills, you can waltz into the pharmacy and ask for up to 5 refills at once, and it's legal for the pharmacist to oblige ... if they deem it appropriate and insurance is not being used.



Just be careful what you say when they ask for a reason ... because in most states it's a felony to lie in order to obtain controlled subs.



The pharmacist also has the perfect right to call the doctor's office and tell them what early refills you're asking for and ask for the doctor's OK. That's not a violation of any confidentiality. If the doctor says no to the early refills, well, you're screwed, because the pharmacist will write a note to that effect on the scrip ... so even if you transfer it to another pharmacy, you'll probably not get any early refills from that scrip, and the pharmacy (and doctor's office) could even put a note in your file saying that you're a "drug seeker."



When i had a scrip for #2 Ambien with eleven (yup, it's illegal) refills and asked if i could have them all at once (not an outlandish request), the Walgreen's pharmacist called the doctor's office and he said no, just dispense two a month. So they sold me the two measly pills and i paid them their (minium) $10 plus tax. Ridiculous and demeaning, huh?



Well, after complaining to the doctor's nurse on the phone the next day, she called in a new scrip for #24, with no refills, and she canceled the previous scrip for #2. Needless to say, i'm looking for a new doctor to be the PCP with my HMO.



The funny thing about this whole escapade is that when i was at the doctor's office and saw that he'd used a single scrip for my Zoloft, Klonopin, and Ambien and wrote down a single "11 refills" (the max for controlled subs is 5), i asked his nurse about the niggardly #2 Ambien and *she* was the one who told me i could ask for all my Ambien refills at once. So that's what i did.

advise you seek legal counsel to wit possible violation privacy law pertaining to your dr-pt relationship

Trampy, first you da*n well should look for another doctor. My shrink is always working out little formulas to get around my insurance Rules.

You perfectly spelled out how much discretion pharmacists have. In my state we can even refill a Sched. II a few days before it is due with a sound reason. If self pay then we need the reason. BUT, if insurance is involved a call is placed to them and 8 out of ten times they allow the refill.

I have personally had my own adderall refilled 5 days before next date-vacation! Just give a logical explanation. One thing you should never do, even if true, is say your meds were stolen. RIGHT. Even a police report does not work for that excuse.

There are no refills allowed on C-IIs. It's federal law.

Trampy, I agree federal law states a CII prescription can not have refills. I haven't seen anything in any of the above post's that violate any doctor patient laws.
Take care. Billylll

Quincy, I just think that's outrageous that a stupid pharmacist thinks he or she can second-guess your f***in doc, and refuse to refill a legit script. If I were a doc, I would be awfully pissed off to know that some jerk*** white-coated doctor wannabe was challenging my prescribing. Especially given that it was not a ridiculous amount of meds. BTW, 2 every 6 hrs. means you could take 8 a day, and you should have been able to fill that even sooner! Thank god for the OP's.

UPDATE and Additional Info: When I went to Dr. # 2, I did NOT use my insurance (payed cash for the visit) and did NOT mention Dr. # 1's name anywhere - (it is one of those "doc in a box, walk in" clinics.)



I did finally get my complete medical record file from Dr. # 1 and spoke to the office manager (who happens to be married to my Dr.) and from what she said to me and from what I can read (handwriting is terrible and they didn't do typed transcription) this is what happened:



Back in the summer, I also went to Dr. # 2 for a visit about my back, I couldn't get in to see my normal Dr. #1. I got a script for 10 Vicodin and had it filled at the drugstore (Longs) across from Dr. #2's office.



I must have, at some point, gotten a script filled at Longs also from Dr. #1 (although I do not remember doing so) and so when I used Dr. #2 again this last time (injured my knee) and filled the script for (worthless) Darvocette at Longs, they must have, in turn, called Dr. # 1's office to let them know I had gotten a controlled substance script from Dr. #2 and then Dr. #1 called Dr. #2 and let them know..... Judging from all the notes, it appears as though that is what happened. It then appears that Dr. #1 took it upon themselves to call a few other chain DrugStores to "enquire" about me..... they did note that over the summer I had a script for 10 Vikes filled at a Fred Meyer pharmacy (that was due to an ER visit on a Sunday) and a script filled also at the Fred Meyer for Lorezepam (from my Psychiatrist for anxiety) and on the last page of my records, it is written (and I quote) "future requests for Vicodin will be denied, drug seeker."



SO! - With that, I am now looking for a new Dr. and will NOT mention my previous one and will use a completely different pharmacy altogether for any meds I happen to receive. I guess one small thing leads to a big chain of events.....it was just weird and shocking because I paid with cash for the visit AND the script from Dr. # 2 (Narcotics seem to be some of the the cheapest meds, cheaper than my co-pay even....)



SO - live and learn and let this be a lesson to all of us, especially me!!!



(Sorry so long, but I had a lot to say)

OH - and P.S. - When I asked the office manager at Dr. #1's office exactly WHO made the call to the other Dr.'s office, she said she had no idea because it is not noted in my chart anywhere that any call was made.......

Well, you won't believe the last few days I've had. This post is about another pharmacy incident I had, but I have had the most horrible few days, I must vent! I was diagnosed with fibro and ankylosing spondilytis about two months ago. I have had to take quite a bit of sick days from work, but I've only been working here three months. Besides the pain, fibro makes you fatigued, clumsy, forgetfull- truly not my ususal mental capacity. My work has suffered. I explained to my boss and co-workers my situation and I thought they understood. The other day went to lie down for a few minutes, and let my coworker know. She said OK-no problem-so I rested for a few moments. Next thing I know my boss stormed in, and he reamed me out! That little bi**h called him behind my back t deliberately get in trouble. Now I have got written up for this incident as well as complaints about my sullen "attitude". Of course Im sullen- its not fun to go to work in extreme pain all day every day, and to experience this fatigue that leaves you barely able to function, plus I have suffered two miscarriages in three months. Im sorry, I just don't feel like faking cheerfulness and chatting all day. All I can do is show up, do my work and leave. So now I have to worry about losing my job because of this illness too. What next?!!
Anyways, yesterday I saw my new primary care doc- she prescribed Xanax for my anxiety. I also see a rheumatologist who prescribed me Ultram to be refilled PRN. Once again at walgreens the nosy pharmacist had a question about how much Ultram I was taking. I had just received my 2nd refill the day before. I get 60 pills with instructions to take up to 8 per day. Now isn't 8 times 7, fifty-six? I can get a new bottle once a week-right? Well then the pharmacist asked if my PCP knew I was getting meds from the other doc, and vice-versa. I know I should have told her to go to he**, but I didn't. Im sure that she placed some phone calls after I left, I just hope my rheumatologist won't cut me off now. Well thats all for now- sorry this is so long -take care everyone.

Mayhem and Quincy, your stories just remind me once again, THANK GOD FOR THIS BOARD! Nosy, nasty health care "professionals" with nothing better to do than rat on someone simply trying to find pain relief will have a special place reserved for them in hell. May they all roast slowly over a hot fire.

I had this very same thing happen to me this summer as well. I couldn't get an appt with (#1-regular Dr.) for 3 weeks but (#2) could see me the next day & I was out of meds! That's an emergency to me ....hehe So I went & got Norco's (which I like better) intead of Lorocet 10's (my regular meds) so it wasn't even the same meds, well still Hydro's but anyway, if (#1) would have ask me about it I would have told him the reason but instead he treated me like a druggy! I also thought my records were CONFIDENTIAL that meaning the Ph couldn't tell anyone (including Dr.s) about my meds......Obviously I'm wrong though. And everytime I would go to #1 he would say well I made my calls to the pharmys this month & it seems you've been a good girl! Can you believe that?? I've been a good girl?? What the [censored]?? I took a peek at my records one day & he had been callin all the pharmys in the area (listed on the front page) to see if I had been gettin other meds! but ya know I don't even want to go back to any of those pharmys because they would now look at me like I'm a druggy!...They actually label you in the computer like that too..... Surely there is something you can do if the Dr is calling around like that. Ya know embarassing ya, labeling ya, just making the Ph's think suspisiously of ya & stuff???.. Needless to say I told that Dr to kiss my butt that I had another Dr that was a heck of alot better anyway & he didn't know who! (Which actually I told Dr #2 what happened & he decided to treat me anyway) I just wanted to tick him (#1) off like he done me But honestly that is the only time I have ever used 2 Dr's at one time. Sorry I got carried away (was mad)
Be Sweet,
Christel

I worked in a pharmacy for several years and there were definately notes in patient files about med abuse and double dipping. And we received calls from Docs all the time about what people were getting and where they were getting from. Be careful out there.

Hospital emergency departments also keep lists of those whom they consider to exhibit "drug seeking behavior", and they share that list with all the other ERs in the area. At least, this was the policy when I last worked in late '95, and perhaps there have been some privacy laws enacted to prevent that, since that time. That was also in Washington state, where I no longer live. In the state I now live in, I've been hospitalized three times in the past year, and each time I've been asked my entire history in the ER, as well as for my list of allergies. When we (again) told them that it was all contained in my old records, a nurse told us that it was "against the law" to access our old records. Huh? Will have to check the laws, but this nurse also got herself fired because she attempted to inject me with a medication which I adamantly refused to accept because I have an extremely adverse reaction to it (Reglan), and she attempted to keep my SO from returning to the room to be with me (I was in shock and could not properly respond to questions).

At any rate, just wanted to reiterate that lists are kept, and doctors, pharmacies, and ER's do access those lists (whether they are strictly legal or not). Be careful.

Your doctor is a JERK! Fire him and threaten him with litigation for defemation of charachter. He may be legally able to check your pharmacy records out, but telling you that you have been a "good girl" is totally insulting! Ive gone through the same thing, and doctors have no right to treat you in a condesending manner. Next time you see him, take a patients bill of rights in with you-and tell him straight to his face that you are offended by his attitude. I would also have my new doctor write him a letter (if he is willing) and have him say that he dosen't think you are a "junkie". Stand up to that old jerk-you have rights that should'nt be violated! Be well-

Christel, might I suggest that you *not* attempt to fight the actions of one doctor by engaging another doctor to join in the fray? I can almost guarantee you that you'll end up on the short end of the deal, and having ever-increasing difficulty getting the medical care you need. Unfortunate as it may seem, the reality is that physicians, insurance companies, and pharmaceutical companies have most of us by the short hairs. While doctors can and do disparage one another in private, they will almost never do it in public - "gentleman's agreement", so to speak.

Try checking with a lot of friends and acquaintances, asking about their preferences in physicians and what it is they like about them. Unless you live in a huge urban area where one can very easily go unknown from one doctor to another, don't burn any of your bridges.

Lastly, I'm not making any excuses for the bad behavior or implied/outright insults of health-care-givers, but 95% of them will always, first and foremost, think of their own career before your pain.

Where can I find a copy of thr Patients Bill of Rights?? I'd like to show that to MY dr. I "fired"... thanks

American Academy of Pain Management Bill of Rights:
http://www.aapainmanage.org/aapm/billofr.html

American Hospital Association Patient's Bill of Rights:
http://www.hepcchallenge.org/manual/appendix_billofrights_final.htm#AHAP

Do You Know Your Medical Rights:
http://www.thehealthpages.com/articles/ar-mdrts.html

If you use an OP, can the state keep track of your Class III rx's? ? For instance, I live in California, but I used an OP doc in New Hampshire. I then had that rx filled in North Carolina. How does California keep track if I use OP's? Or do they?

Almost all the states with electronic prescription monitoring use it only for C-IIs. Hawai'i's program does not limit them to C-IIs, on paper at least, so the Dept. of Public Safety there can add any controlled substance to the list of meds they monitor ... but they're supposed to only add drugs that are a public health and safety concern, such as any drug that's widely abused.

Scrip monitoring means that the pharmacy in a state with that program has to report all fills that meet the state requirements to their own state program. It doesn't matter where the customer is located. It depends on where the pharmacy is located. Let's assume that someone is using multiple OPs and getting multiple overlapping fills from pharmacies located in a state with monitoring. All those fills will be reported to that state. Then, if the state monitoring authorities there think you might be violating a law, they can inform local law enforcement where you live.

The scrip monitoring programs take away some of your privacy rights. Pharmacies in those states are required to give your (normally) confidental info to law enforcement even if the scrips are valid and confirmed by the doctor's office.

Nevada also monitors more than Cll's. There is a link somewhere...that lists the states and what each monitors.

North Carolina is not one of them.

I found the link...from page one of this thread...here it is: State Monitoring

Thanks all. It's hard to get all of this straight sometimes. I don't feel like I'm doing anything wrong, but I don't want a federal agent showing up at my door when all I'm doing is getting rid of a headache.

Unless you use insurance or tell the state of California...or use a pharmacy in that state...I don't foresee them having that information.