One-fifth of Trauma Patients ‘Doctor Shop' for Narcotic Prescriptions

As many as 20% of orthopedic trauma patients seek out multiple doctors, or “doctor shop,” for narcotic prescriptions, according to a study released at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting.

For the study, researchers from Vanderbilt University tracked 151 adult orthopedic trauma patients throughout 2011 using Tennessee’s Controlled Substance Monitoring Database (CSMD) to compare those with a single narcotic provider to those with multiple prescribers. The investigators concluded patients who doctor shopped received 7 prescriptions on average and more medication for a duration of 110 days, while those with one provider averaged 2 prescriptions with a lower daily amount totaling 28 days.

“I knew it would be a significant number, but I didn’t realize it would be one out of every 5 patients who walked into my office was also getting narcotics from somewhere else,” senior author Hassan Mir, MD, assistant professor of Orthopaedics and Rehabilitation in Vanderbilt’s Division of Orthopaedic Trauma, said in a statement.

Still, Mir said the findings were not completely surprising, given that Americans make up less than 5% of the world’s population, yet consume 99% of its hydrocodone supply and 80% of its opioid supply.

Study participants with less than a high school education were 3.2 times more likely to doctor shop. Additionally, those who had a history of preoperative narcotic use were 4.5 times more likely to seek out multiple providers.

Although Mir could only speculate why trauma patients doctor shop, he doubted that uncontrolled pain is their motive.

“I don’t think people in different countries hurt less than we hurt,” he said. “I have done international work where people are happy with a Tylenol, versus here where they need high-dosed narcotics, and it just doesn’t add up for the same injury.”