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Doctor and Pharmacy Shopping for Controlled Substances

Peirce, Gretchen L. PharmD, MS*; Smith, Michael J. PhD*; Abate, Marie A. BS, PharmD*,†; Halverson, Joel PhD*,‡

doi: 10.1097/MLR.0b013e31824ebd81
Original Articles

Background: Prescription drug abuse is a major health concern nationwide, with West Virginia having one of the highest prescription drug death rates in the United States. Studies are lacking that compare living subjects with persons who died from drug overdose for evidence of doctor and pharmacy shopping for controlled substances. The study objectives were to compare deceased and living subjects in West Virginia for evidence of prior doctor and pharmacy shopping for controlled substances and to identify factors associated with drug-related death.

Methods: A secondary data study was conducted using controlled substance, Schedule II–IV, prescription data from the West Virginia Controlled Substance Monitoring Program and drug-related death data compiled by the Forensic Drug Database between July 2005 and December 2007. A case-control design compared deceased subjects 18 years and older whose death was drug related with living subjects for prior doctor and pharmacy shopping. Logistic regression identified factors related to the odds of drug-related death.

Results: A significantly greater proportion of deceased subjects were doctor shoppers (25.21% vs. 3.58%) and pharmacy shoppers (17.48% vs. 1.30%) than living subjects. Approximately 20.23% of doctor shoppers were also pharmacy shoppers, and 55.60% of pharmacy shoppers were doctor shoppers. Younger age, greater number of prescriptions dispensed, exposure to opioids and benzodiazepines, and doctor and pharmacy shopping were factors with greater odds of drug-related death.

Conclusions: Doctor and pharmacy shopping involving controlled substances were identified, and shopping behavior was associated with drug-related death. Prescription monitoring programs may be useful in identifying potential shoppers at the point of care.

*School of Pharmacy, West Virginia University

Department of Clinical Pharmacy, West Virginia University School of Pharmacy

Department of Pharmaceutical Systems and Policy, Robert C. Byrd Health Sciences Center (North), West Virginia University School of Pharmacy, Morgantown, WV

Pressent address: Gretchen L. Peirce, College of Pharmacy, The University of Oklahoma Health Sciences Center, 4502 E 41st St, Suite 2H30, Tulsa, OK 74135-2512.

Pressent address: Michael J. Smith, College of Pharmacy, The University of Oklahoma Health Sciences Center, 4502 E 41st St, Suite 1H09, Tulsa, OK 74135-2512.

Supported in part by a grant from the National Institute of Justice in the development of the Forensic Drug Database.

The authors declare no conflict of interest.

Reprints: Gretchen L. Peirce, PharmD, MS, SAC, 4502 E 41st St, Suite 2H30, Tulsa, OK 74135-2512. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.