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Top 10 Signs Your Patient May Be a Drug Seeker
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Scrubs Magazine | Brady Pregerson, MD & Rebekah Child, RN
November 02, 2009
Let’s face it: We’ve all doubted certain patients’ complaints of pain. We’ve all wondered whether their “pain” was really a not-so-cleverly disguised cry for a cheap fix. So how do you know if your patient is in pain—or just wants drugs?
In Part I and Part II of our Pain Management series, ER doc Brady Pregerson and Nurse Rebekah Child examined the challenge of accurately assessing a patient’s pain, as well as the perils and pitfalls of simply dispensing the dope any time a patient asks. In this article, they point you to signs and symptoms that may indicate your patient has more than physical pain on his mind.
How to Recognize a Seeker
Dr. Brady: What do I do when I have a patient who I think is feigning illness in an effort to get narcotics? It depends.
First and foremost, I do my best to make sure I’m not missing something. If you let your guard down, you will eventually get burned.
I also find it useful and relatively simple to check and see how often the patient comes to the hospital. If she’s here less than five or six times a year, I worry less than if she’s here every month. But you have to be careful with this test, as some patients with real disease, such as sickle cell disease, really do need our services that frequently. Plus, in urban areas, some patients just visit different EDs every month; checking their home address may give a clue to this one.
Another thing I like to do is call the patient’s doctor, if she has one, to get more information.
kwindham1
5 days ago
10 comments
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.
ckruszka
14 days ago
80 comments
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.
schnauzermom
16 days ago
2 comments
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.
daphnie3677
20 days ago
14 comments
I agree that it is hard to tell with these issues. They are definately very good at pasttime.It makes our job really hard.