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It isn't like there's an automatic cross reference any time you go to a doctor.
Where people usually get caught is at the pharmacies, since that's where most places have their tracking. When it isn't there, it's via insurance, since even if pharmacies didn't track prescriptions against a database, the insurance companies that pay for your meds already do.
Doctor shopping, on the level you're asking about, it tends to be about finding providers that will just write a prescription with little or no difficulty. That's the easy part of it. Doctors tend to either refuse to do pain management at all, or will only do it short term; but the ones that will do it short term tend to still be willing because they know they aren't going to end up with hassles as long as they aren't providing you with a steady stream. And, they also know if you're "drug seeking" as opposed to treatment seeking, that you'll get noticed at the pharmacy or insurance company.
Now, if you're actually a chronic pain patient, you can find doctors that will act as your pain management, but it's going to be rare as hell, and they'll keep an eyeball on you. But you'll usually get turfed to a pain "specialist", and have to jump through whatever hoops they prefer.
It's the same with things other than opiates, like benzos, ambien, etc that have a recreational use aspect, or get abused heavily/are addictive. But opiates are more or less the big doctor shopping target. Benzos are a close second, but GPs are much more likely to refer you to a psychiatrist that's set up for handling the underlying issue than with opiates.
It has gotten a shit ton harder to sustain doctor shopping though, because there's so many possibilities to get flagged now. You don't even want to know how often chronic pain patients run into issues if they make the mistake of seeing a different doctor because their primary is out of town, or retires. And gods forbid you switch pharmacies when there's a shortage of a medication that's controlled like that. You can end up being refused anything without jumping through a million hoops.
I've seen people in their eighties flagged for pain meds. Like, who gives a fuck if they do become chemically dependent, they're not going to be a long term risk for anything if they're dealing with chronic pain in the first place. Too many co-morbidities.