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How does Doctors find out if a patient is pharmacy shopping?

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I'm not sure that I understand what you mean by "pharmacy shopping"?  There are many procedures now put in place to safeguard the patient, the pharmacy and the doctor from any questionable practices in prescription tampering.

1.  No pharmacy will accept any RX script from a patient unless it is written by hand, in ink, on a doctors Rx pad which has his license on it.  The pharmacy will usually call that doctor to double-check the authenticity of the prescription.

2.  Most all Rxs are paid for by some insurance company.  the Ins co. keeps very good records on when the Rx was filled and by whom. 

3.  No pharmacy will accept a call-in Rx order except from a verified doctor's office and that must be followed by a FAX with the dr's license number.

4.  No narcotic Rxs are given to a patient without signing a bunch of papers. 

5.  There's no way you could take the same Rx to several pharmacies to get filled.

Doctors--and pharmacies--are under a lot of scrutiny to ensure patients don't receive multiple drugs from multiple pharmacies, particularly when it comes to benzos (valium/diazepam, clonazepam, alprazolam/xanax) and painkillers like vicodin/hydrocodone and oxycodone.  I work for a large health care system and they have a computerized program which allows a doctor to pull up all the "scripts" a patient is filling at pharmacies throughout the State.  Also, even if you use the same pharmacies within a health care system, there are only so many times--I think it's two--you can move the prescription from pharmacy to pharmacy.  I recently ran into this myself when I moved my ambien prescription from one site to another and then back to the original site and it was cancelled even though I wasn't filling it ahead of time and had several refills left.  I was told ambien is a controlled substance and can't be moved more than twice--even though I was doing it for convenience.  And I then had to call my doctor's office, explain what had happened, and wait for them to call the pharmacy, send in a new prescription via fax then have the doctor call the pharmacist to confirm he had authorized the new prescription.  The calling part drives some of the doctors nuts as it is another step they need to take during their jam-packed days but without the faxed or dropped off prescription and now the call, the pharmacy will not fill the prescription.  They also are taking steps to make sure patients can't use multiple aliases to get drugs and, at least in the county and State where I live, all of the Emergency Departments are linked together to list patients treated and what drugs they were given (including any samples) so a physician knows within 24 hours what their patient was given even if they went to an ER that's not in the same health care system. 

Recently, a doctor friend told me the worst thing a patient can do is to have a record of receiving benzos or any controlled substances from multiple pharmacies as that sets off red flags immediately.  In order to protect their own medical licenses, doctors like this one will usually give a patient one chance to get everything filled at the same pharmacy--and if the patient doesn't comply, that's it; the doctor will not authorize any more prescriptions for them again.  So it's pretty serious. 

On the good news side of the equation, it really is in the patient's best interests to use the same pharmacy.  With all the drugs available these days--and so many people take something--if a pharmacy has all of them on record, they can advise patients about potentially serious and possibly deadly interactions and avert any problems.  Whenever you pick up a new prescription from a pharmacist, do ask questions about interactions and make sure they know about any other things you are taking, including vitamins and herbal medicines as they can also interfere with the way a drug may work in your system.

one time ...like 3 yrs ago a friend dropped off a script for atuss ms..a narcoticcough medicine and put a refill on it...he did, not the dr. So the dr office called me saying they were informed the  script had been changed and not to laet happen agn. Well today the dr prescibed teh same thing and when i went to get it was a phone call then....well the dr doesnt want to do the cought medicine now. im like why....is there a flag on my acct at the pharmacy saying not to give me that now??

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