How Does Doctor Shopping Impact The Opioid Epidemic?

How Does Doctor Shopping Impact The Opioid Epidemic?

Surprisingly, the non-medical prescription of drugs, including opioids, continues, with only states holding legislation against this dubious practice smothering the flames helping stoke the opioid addiction fire. Since 1999, deaths from prescription opioids have quadrupled, alongside opioid sales of painkillers such as oxycodone (Oxycontin) and hydrocodone (Vicodin). But this hasn’t stopped opioid abusing patients from trying to nab a couple of extra pills by ‘doctor shopping,’ the practice of hopping from physician to physician and playing the numbers until finding a doctor who will meet the patient’s desire for a few extra pills. Luckily states nationwide, alongside the insurance and healthcare community, are becoming increasingly aware of these issues, and are attempting to stem this contributing facet of the epidemic through the use of prescription drug monitoring programs (PDMPs). And a new study has shown them astonishingly successful.

An Easy-to-Use, Effective Means of Curbing ‘Doctor Shopping’

Physicians utilizing these state-run electronic prescription databases, mandatory in some states and voluntary in others, offers them access to each patients prescription history, and the opportunity to see drug types and quantities prescribed to patients before breaking out the prescription pad. In addition to thwarting potentially deadly drug interactions and excessive dosages, a recent study has shown that these programs are highly effective for reducing the non-medical prescription of drugs, boasting a whopping 80% reduction in the odds two (or more) doctors would dole out pain relievers for non-medical reasons to a single patient in states with mandatory PDMP use, and slashing the odds 56% in states with voluntary participation. Every state except Missouri now has one of these programs. Other studies have also shown states tracking a wider range of potentially addictive medications and updating databases weekly witnessed the biggest reduction in overdose deaths.

Won’t Patients Turn to Illicit Substances?

Public health advocates have had this worry for quite some time, but the current study pointing to the massive, 80% reduction in non-medical prescription of opioids in those states with mandatory programs also uncovered some reassuring news. PDMPs did not, in fact, lead to an increase in doctor shopping individuals turning to heroin. This offers hope for the promise of PDMPs as part-and-parcel of a multifaceted, comprehensive strategy toward fighting the nation’s opioid epidemic, which steals the lives of 91 Americans each day.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit

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New Opioids Reduce Pain – and Addiction Risk

A new generation of opioid drugs are on the horizon, possibly offering the much maligned class of drugs a second chance to make a good impression. After years of opioids like oxycodone and fentanyl driving up drug addiction rates nationwide, a second subset of once odious opioids is being introduced, touting all the painkilling power of its conventional counterpart – less the dangerous and deadly side effects.

A Different Approach

While pharmaceutical companies continue to crank out new prescription formulations geared toward treating the side effects of opioid drug use and addiction rather than eliminating the painkillers, researchers are seeking a new path to both help patients – and repair the reputation of opioids. To combat ever-rising opioid addiction rates and overdose deaths, researchers are working with three (new) compounds:

  • Oliceridine
    Created by Trevena, this drug has been given preferential regulatory treatment by the FDA.
  • Mitragynine Pseudoindoxyl
    Derived from leaves of the Southeast Asian kratom plant, this compound has demonstrated a decreased addiction risk in mice.
  • Compound PZM21
    Early testing has produced results that, according to researchers, are unlike those seen from other potential painkiller compounds.

Mitigating Risks

Working like morphine to bind to proteins in the brain, spinal cord, and other organs, this new family of opioid drugs activates a different signaling pathway than their predecessors, using a route through which information flows from one molecule to another. These essential differences are hoped to decrease the risk of addiction, as well as the leading cause of overdose death – respiratory depression – the elimination of which has been deemed an essential goal.

Ensuring Optimal Outcomes

To combat the high economic and human/personal costs of opioid abuse, dependence, and overdose, as well as to ensure a post-injury recovery process that yields maximum results and quality of life, ANS Solutions has developed Pharmacotherapy Review. This unique and industry-leading approach far surpasses run-of-the-mill drug utilization programs, providing comprehensive care and an attention to detail that protects injured workers and workers’ compensation payers alike against the concurrent risks and costs of unnecessary treatment regimens, including the over-prescription of opioids, through…

  • Exceptionally credentialed Legal Nurse experts, Doctors of Pharmacy, and staff.
  • Face-to-face collaboration.
  • Consolidation/coordination of drug therapies between all prescribers.
  • Identification of excessive dosages.
  • Weaning programs for over-prescribed narcotics.
  • Consideration of evidence-backed treatment alternatives.

Set off on a new path to injury and disability treatment. Uncover the benefits of Pharmacotherapy Review from today.

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Alabama Doctor Arrested In Connection with Matt Roberts of 3 Doors Down Overdose Death

In mid-August of this year, fans were stunned by the death of 38-year-old Matt Roberts, former guitarist of 3 Doors Down. Alabama physician Dr. Richard Snellgrove was arrested November 16th for allegedly providing the rocker with drugs outside the course of his professional practice. Snellgrove prescribed some five different medications, including methadone, hydrocodone, lorazepam and fentanyl — all prescribed in the names of different individuals, but intended for Roberts.

Slated to perform at a charity event for veterans, the rocker’s father, Darrell Roberts, who often traveled alongside the star, learned of his son’s death the morning following rehearsals. The elder Roberts was informed his son was “either asleep or passed out in the hallway of his hotel” by authorities. Roberts’ father indicated that his son had been fighting a prescription medication addiction to combat his anxiety since joining the band.

A Serious Issue Beyond Over-Prescription
While Roberts’ father noted that he didn’t have any bitterness or anger toward the doctor, he drew attention to the seriousness of the issue in the medical community across the U.S. Prescription drug abuse causes the largest percentage of deaths from drug overdosing, with opioid painkillers the most common culprit. Roberts is among a string of stars over the past decade, including Prince, Whitney Houston, Michael Jackson, Brittany Murphy, Heath Ledger, and Anna Nicole Smith – alongside thousands of other unnamed “average” Americans – sons, fathers, mothers, daughters, brothers, sisters, and friends – all lost to the prescription drug abuse epidemic sweeping the nation, unheeded by age, race, gender, or income level.

Re-Thinking “the Norm”
In chronic pain treatment, particularly where opioids are concerned, there seems to be a disconnect between a drug’s approval for use and its potential for harm, leading to over-prescription and deadly drug interactions. This is why ANS developed its unique pharmacotherapy review program, the only drug utilization review system in the industry with a hands-on, state by state jurisdictional approach. Sometimes to help an injured worker, “it takes a village”, and the ANS face-to-face collaborative process uses locally based legal nurse experts to bring doctors, patients, insurers, and legal representatives all onto the same page. Other drug utilization processes act superficially and fail to follow up, but the ANS process consistently achieves the most impactful patient outcomes while producing the lowest MSA’s and most improved loss ratio’s in the industry. All this while offering a risk free “No Fee Assurance” guarantee for WC payers who wish to try the program.

To truly improve patient treatment outcomes and stop the opioid epidemic try scientifically-based, cost-effective pharmacotherapy review programs. Contact us today.

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New FDA Warning: Avoid Prescribing Opioids & Benzos Together

In a recent announcement by the FDA, boxed warning labels will now be required to advise against the utilization of prescription opioid pain medicines alongside benzodiazepines unless no other adequate alternative treatment method exists. Warnings about the risks of combining these two classes of drugs are nothing new. Already required on drug warning labels, additional black box warnings are an effort by the FDA to reach out to those who may have “missed the message.”

Classified as Central Nervous System (CNS) depressants, each drug alone can trigger side effects such as respiratory depression (slowed/labored breathing), coma, and death, the effects of which are enhanced in combination. For clinicians living in the dark, these risks will now be spelled out in the black boxes of 389 different pharmaceuticals. Additionally, opioid painkillers such as oxycodone and benzos like alprazolam (i.e. Xanax®) – even the combination of opioid cough medicines with benzos and other CNS depressants (like alcohol) should be avoided. If the drugs must be used together, clinicians have been advised to warn patients of these risks.

The FDA’s latest measure in battling the nationwide epidemic of prescription opioid abuse, essentially classifies this drug combination in the “last resort” genre. Rates of emergency room visits resulting from the nonmedical use of this combination of drugs has tripled from 2004-2011, with the rates of drug-related deaths following suit. According to the FDA, these rates coincide with a 41% increase in patients prescribed both an opioid and benzo between years 2002-2014. The measure is a win for public health officials from 17 states and territories and 13 cities who petitioned the agency in February to require the boxed warning in an effort to fight the routine but unproven treatment method.

Bridging the gap is possible, however, with the help of clinically proven injury and disability treatments from ANS Solutions. Our expert medical legal nurse consultation services and Pharmacotherapy Review Program get the result patients need – without side effects – protecting and enhancing the quality of life for injured workers, and guarding against the medical and financial risks of unproven treatment methods with scientifically-backed protocols. Are you ready to set out on a new path in worker’s comp injury management? Contact today!

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Prescription Drug Abuse Knows No Bounds

Earlier this month, the American public was shocked by the untimely death of iconic pop legend Prince. Though autopsy results remain unreported, media coverage alleges that Prince was struggling with a prescription pill addiction to Percocet, receiving treatment for an opioid overdose just days before his death.

This post is not to re-hash celebrity news from various gossip reports but rather to point out the depth and breadth of the prescription drug epidemic. In the past decade, Whitney Houston, Heath Ledger, Brittany Murphy, Anna Nicole Smith and Michael Jackson were just a few other celebrities to overdose on legally prescribed medication. These very public deaths reflect a larger wave of prescription drug abuse across the United States, something ANS has touched on frequently in our blog posts.

A Proactive Approach to Patient Care

There seems to be a false sense of security that accompanies the use of doctor prescribed pain killers- the risk of addiction may not be stated clearly enough or is just not taken seriously.

At the end of the day opioid addiction knows no boundaries, spanning all races, ages, genders and income levels.

When it comes to chronic pain treatment, a focus on the education of well-being of the injured worker is crucial. That is why ANS developed pharmacotherapy review – not only as a medical cost containment strategy for payers, but as a proactive approach to minimizing inappropriate, duplicate or unnecessary treatment regimens, as is often seen with opioid based prescription pain killer treatment regimens.

Through in-depth reviews of each patient’s medical history alongside the assessment of the practices of prescribing physicians, our legal nurse experts are able to uncover underlying illnesses, behaviors and risks, and then implement actionable recommendations to existing treatment plans, addressing potential issues before they can lead to serious adverse events.

Concerned about the growing opioid epidemic and how it’s contributing to treatment outcomes and your large loss workman’s comp claims? We can help, contact ANS today at


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No Proven Benefit for the Use of Opioids in Chronic Pain

Millions are addicted to or dependent on prescription opioids. Worse than the dependency, over 200,000 deaths are attributable to prescription opioids, as well as hundreds of thousands of overdoses. What’s the biggest contributor to the epidemic, you ask? Most commonly, it’s the inappropriate prescription of opioids for the treatment of issues like musculoskeletal disorders, chronic low back pain, headaches, and other issues.

Insights from a Leading Pain Expert

A recent study conducted by leading pain expert Gary Franklin, MD, MPH, V.P. of Physicians for Responsible Opioid Prescribing, provides substantial evidence that prescribing opioids for chronic pain offers no real benefit. Franklin has been striving to shed light on this issue which is believed to be contributing in large part to the prescription opioid abuse epidemic sweeping the nation. Opioids such as hydrocodone and oxycodone have increased in prescription from around 76 million in 1991 to nearly 207 million in 2013, making the U.S. the biggest global consumer for these products at nearly 100% of word consumption for hydrocodone, 81% for oxy. Most notably, Dr. Franklin’s research found clear evidence of dose-dependent risk for serious harm:

  • A dramatic increase in death with opioids administered at a dose of 100mg MED (morphine equivalent dose).
  • A risk of overdose 2-5 times higher when the above MED runs between 50-99mg.
  • Doses lower than 100mg MED still result in overdose – even without long-term therapy.
  • Opioids administered in combination with benzodiazepines, sedative-hypnotics, or muscle relaxants dramatically increase the risk for harm.
  • Double the risk of remaining on disability 1 year for those treated with opioids for at least 7 days (cumulative dose: 150mg MED).

Reversing the Trend

Believed to be the direct result of poor research and outdated teaching practices, the most important step toward reversing the opioid epidemic is simple- putting a stop to improperly prescribed opioids particularly for chronic pain. To aid this effort, t­he American Academy of Neurology and a number of states have produced product guidelines advising against the use of opioids for the treatment of musculoskeletal conditions, headache, or fibromyalgia, and additionally advising physicians to proceed with caution when initiating opioid therapy for pain or long-term use. (Since released, the guidelines created as a result of the drug utilization review have effected a 30% sustained decline in overdose deaths and a substantial decline in injured workers on chronic opioids in Washington State.)

Evidence-based Alternatives

Opioid therapy is not necessarily the only answer to treating chronic pain. Drug utilization review programs such as ANS Pharmacotherapy Review can provide alternative therapy recommendations. ANS deploys an exceptionally credentialed network of nurse experts to deliver recommendations in face-to-face meetings with treating physicians. These recommended treatment options are equally, if not more effective than opioids. Better still, they offer improved quality of care and quality of life for the injured worker.

If the pitfalls of opioid therapies are taking over your workers’ comp claim settlements, the proven drug utilization review protocols at ANS Solutions can show you a better path. Optimized outcomes for the injured worker are possible. Contact ANS today or visit


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