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Top 10 Signs Your Patient May Be a Drug Seeker

Top 10 Signs Your Patient May Be a Drug Seeker

Scrubs Magazine | Brady Pregerson, MD & Rebekah Child, RN

Nurse Rebekah:

Top Ten Signs Your Patient May Be Seeking Narcotics Inappropriately

1. He knows which ER docs have a proclivity for dispensing narcotics and schedules visits around their work hours.

2. She remembers your password for the Pyxis—and prompts you when you forget it.

3. He knows the exact dose of medication that will kill the pain: “4 mg of Dilaudid IVP usually works for me.”

4. She’s allergic to Toradol and morphine.

5. He went into a clinical depression when many emergency rooms stopped stocking Demerol.

6. She can relate to Nurse Jackie.

7. He’s been to the ER 15 times in the last year for pain management and yet can’t make it to the pain clinic for his appointment.

8. She balks at the idea of narcotics being given subcutaneously.

9. His holiday wish list looks like a Pyxis report.

10. Her primary physician not only knows her name, but so does the doctor’s wife, his three kids, the pharmacist and the pharm tech at the local drugstore.

Yes, this list is somewhat tongue in cheek, and sometimes the hints may be more subtle than directly depicted above. But all kidding aside, remember that these drug seekers get very good at their pasttime of hoarding meds. Don’t disregard any suspicion as an overreaction because it may lead to more than you realize.

These people, for their own safety and the safety of your license, must be dealt with and their addiction must be treated. Do not be afraid to report them!

More on

In Career Advice: The Candyman Conundrum
In Career Advice: Give Drug Seekers the Benefit of the Doubt
In Career Advice: Prescription Drugs

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  • Photo_user_blank_big


    about 2 years ago


    grrrr to brownie point seeking, wannabe super sleuth healthcare professionals who figure they have a finger on some clandestine pulse: you can shove this smartarsed "tongue in cheek" article on patients "seeking" relief from their pain (be it acute OR chronic). Nurses are human too ... that's why it takes TWO of them to dispense pain relief ...clearly they are the ones who can't be trusted!

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    about 2 years ago


    Yes I was told in nursing school that the patient's pain was what they said it was. I had concerns about giving patients oxcontin and such because I know how addictive they are, but our teachers assured us that "if they are prescribed it, they are not 'addicted'. They never went over the types of behaviors we might see from patients who are prescribed these medications long term or what to do if we find a patient who should be weened off but has fallen through the cracks (which is a failure of the health care system and NOT the patient, and happens often). But that's not the case. I see nurses say 'oh she's a drug seeker", they are refering to that poor woman who materializes next to the med cart 15 minutes before her dilaudid is scheduled,who the doctor never tries to ween off. We are not talking about people who are buying these drugs on the street. We are talking about people who are addicted to medications they are prescribed, who are behaving in a way that represents addiction because they are on addictive drugs. This is your responsibility as a nurse to recognize that they need help and to address it with them. Please consider joining me in educating other nurses on how we can help these poor lost souls.

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    over 3 years ago


    My sister worked in several drug rehab centers and she told me that the first sign in your list: "He knows which ER docs have a proclivity for dispensing narcotics and schedules visits around their work hours" is the predominant sign encountered when treating people with drug addiction. The signs are important but the more important aspect is the set of measures to help the patient, it would be nice to have a "TO DO" list when you observe one or more "Signs Your Patient May Be Seeking Narcotics Inappropriately".

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    over 3 years ago


    Well, all of these sings may not be obvious for everyone, drug addicts have their ways of hiding it but if you pay extra attention you might see the signs. I read some interesting details about drug addiction behavior on a drug rehab Washington resource, maybe this will share some more clues on how to spot a drug seeker.

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    over 4 years ago


    Although meant to be tongue in cheeck I think this article is way too irresponsible. This is not an issue that can be glossed over quickly or joked about. Unmanaged pain is a shame but so is drug seeking. As medical proffessionals it is our duty to respond with as much integrity to each individual situation as we can. I work on a detox unit and I see all different situations. I don't have the answers to these problems but I do know that none of these patients are "happy" with the situation that they are in and it is way past time for Dr.'s and nurses to reassess how these patients are cared for and medicated. We are just as much to blame and need to take responsiblity for our part in the equation.

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    about 5 years ago


    I've been an ER nurse for 10 years, and I've labeled folks this way. Well, I recently had a serious injury, with very prolonged, painful recovery. Getting relief from pain, so it doesn't mess with your head is ALMOST IMPOSSIBLE. I am so tired of being in pain, but still don't want to ask for help, because you see the reactions. I just suffer through it, and have for awhile. I now know there is more than one way to look at it. My experience has made me NOT ask for meds.

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    about 5 years ago


    I thought the going trend was that if pt's were "seeking" then this meant pt's were not getting adequate pain relief. JACHO was trending this, and there has been a movement to change doctors and nurses thinking from blaming and accusing pts of drug addiction, to having the medical profession take the stance that their pain my not be being controlled adequately.

    Being a nurse 26 years, I can honestly say that at one time I too labeled pts as "seeking'. I have however realized that maybe its the medical profession that are unfairly judging and woefully undermedicating pt's for pain relief. As a result, I have advocated for changing pt's pain med regimen or giving meds sooner if relief is not being accomplished.I also encourage my pt's to call for pain relief before it becomes unbearable and difficult to manage.

    Instead of labeling pts we should be looking at what we as nurses may be missing in obtaining optimal pian relief. Many a pt has been relieved to know that I'm on their side, and not accusing them of being drug addicts.

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    about 5 years ago


    I am so angry with this site for posting such misinformation. I am a NP certified in and specializing in pain management. This cavalier approach to the very real problem of unreleived pain is one of the top problems with healthcare providers. Many who are considered "drug seeking" are actually relief seeking. The consequences of untreated pain are many--physiologic, psychological, financial. The impact is not just on the person experiencing pain and those close to them. It effects all of us. There is a huge impact on society--lost wages, decreased productivity, links with emotional and psychological problems, increased visits to healthcare settings. I understand that in the ED setting you have a higher chance of coming across diverting or drug seeking patients. But statistically the numbers are small. Posting such opinionated info, not backed up with clinical evidence, influence attitudes. Attitudes of healthcare providers has been recognized by research as one of the biggest barriers to appropriate and adequate pain relief. Educate yourselves. There are quidelines, JCAHO mandates, professional organizations, position statements, advocacy groups. Obviously NursingLink missed the news that this has been deemed the decade for pain control and research. Why put out a "list" like this and interview clinicians who are not recognized leaders, practioners, researchers in the specialties of pain management or substance abuse? You do a disservice to our profession and our patients. Oh and by the way---why is it a "sin" to know the name and dosage of an opioid (please notice I am using the correct term, not "narcotic")? We educate patients to know such information about other medications.

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    about 5 years ago


    I agree that it is hard to tell with these issues. They are definately very good at pasttime.It makes our job really hard.

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