P2 Mobile Logo

Search form


13 Red Flags Your Pain Patient is a Drug Seeker

13 Red Flags Your Pain Patient is a Drug Seeker

  • ©sevenMaps7/Shutterstock.com
  • ©AndreyPopov/Shutterstock.com
  • ©Kubais/Shutterstock.com
  • ©bacho/Shutterstock.com
  • ©LisaS/Shutterstock.com
  • ©TylerOlsen/Shutterstock.com
  • © Photographee.eu/Shutterstock.com
    © Photographee.eu/Shutterstock.com
  • ©mangostock/Shutterstock.com
  • ©Robert Kneschke/Shutterstock.com
    ©Robert Kneschke/Shutterstock.com

As doctors, we know the complications the opioid epidemic can cause. We have all seen patients who were seeking drugs, whether we recognized it or not. And I would hazard a good guess that we've all fallen for prescribing controlled substances to a seeker at one point or another in our careers.

Doctors and other healthcare providers want to do our best for our patients. When they are in pain, we want to alleviate it. But, we are often conflicted when we are treating a patient in pain because so many tried to scam us in the past and we cannot honestly tell which ones are telling the truth or not.

One sad case that I saw was a patient in her 20s who came to me as a new patient with a recurrence of her Non-Hodgkin's lymphoma. She wept because she knew the chemotherapy would make her long hair fall out again. Needless to say, after weeks of trying to retrieve her records, I learned that she never had any kind of cancer, but rather a history of drug seeking behavior. No one would conceive of denying a patient with cancer pain medications. Yet, who would expect any one to lie about having cancer?

As the opioid crisis flourishes in this country, we all need to be super-vigilant and help take these medications off the street and not fuel patients' addictions. Sadly, the true losers are patients who are suffering legitimate pain. Many of them cannot get the pain relief they need because of those who abuse or divert these drugs.

There is a finger pointing on who is to blame. The truth is as long as we hold the prescription pad, we are part of the problem. Thus, we need to be the solution and hopefully the others will join our side of the battle. One positive is that most states have prescription registries where we can look up controlled substances our patients have received and this has made our detective work much easier. However, it is not always up-to-date and often doesn't cross state lines.

As such, here are some red flags that can help you recognize when a patient is drug seeking.

Click here to view the entire slideshow.

Physicians Practice


What is also needed is an article/program on activities and behaviors which help confirm the need for medications. Most doc's will provide a letter of introduction for a pt. moving to different area along with records. It is also pt's who do the opposite who usually are legit.
Never call early
Never lose their meds or drop them in toilet
Are still active (exercise and work full time)
Aren't NO shows
Don't drink
Expect to and readily sign narcotic agreement form.

Jeff @

Excellent points and I agree. The patients who need these meds are truly being harmed.

Linda @

Tahe boxing lessons, it a miracle anti-pain medication! I can't tell you how many patients have jumped up from wheelchairs walkers even when I tell them "the methadone program is on 3rd ave, the bus to the 24 hour detox at saint Barnabas is on the corner, I'll give you a Doctor's letter if you ain't got $3.00 so the driver let's you on free, I'll talk to you about Suboxone, but take that thug shut outside cause If you don't I'm a put my board certified foot in your ass and I ain't even gonna say shot when your parole officer calls 'cause I'm old-school, motherfucker and I don't rat on nobody for nothing".
They've call me outside, some have threatened me, one told an HMO that I was drunk! One called me a 'cabron' on Prospect Ave. I took off my shirt,
'No vas a hablar con migo assi"
He just waved me down, later that day he was hanging out drinking beer(!) in the front of the Clinic. 'Este Medici tiene pecho' I overheard to his pal. I must confess it was the among the most gratifying compliment of my medical career.
After that he became a model patient...

Joseph @

Might have been a good idea 30 years ago when I started. Or in high school. I started my adult career as a Marine infantryman, did practice martial arts for 25 years but then there is reality. Knives, guns, baseball bats, and groups of the thug's buds who were also hoping on a score. Oh, I almost forgot about driving over someone by "accident." Did I miss arson? And then there is the practice of going after someone's family to teach them a lesson.

No, I don't believe on planning to fight every patient who seems threatening as one of the more prudent suggestions. Perhaps being firm and respectful will allow you to practice longer and help to keep your family safe.

Eric @

Wellness checks by the county sheriff departments or local police departments assist when the RED FLAGS go UP......also.
Robert D. Shedden, D.O.


In some areas, I think the police are so overhwelmed, they don't have time unless it is a big drug ring they can bust. But yes, to solve this crisis, we need the police in many cases.

Linda @

Just to reiterate what others have said - this is a slideshow, you have to click the arrows on the slides or the thumbnail photos below the photos to move through it. If you are having trouble doing that, please email editor@physicianspractice.com and we will get this squared away. Sorry for any inconvenience and thanks for your interest in Physicians Practice.

Gabriel Perna, managing editor

Gabriel S @

Those who cannot read the article. It is not really an article except the overview comments. It is a PowerPoint type set of slides with the 1st one titled "13 Red Flags Your Pain Patient is a Drug Seeker." If you hover your mouse over the right edge in the middle of that 1st slide you'll see an ">" appear, you click on it and it'll take you to the next slilde. Repeat until you see all 13.

Having said this, for some reason folks think we like clicking through these to read them. I wish they'd just list them at the end of the authors comments so I too could just print them and share with our other Physicians and Providers. Are you listening, Physician Practice?

Donald @

Thanks for your comment and help in assisting others. We'll take your 2nd comment into consideration. We've been running slideshows for a quite a while and have never received a complaint about the format - just that people had trouble navigating it. However, if more people are feeling the same way, we'll talk about revising the format.

We're going to include a PDF that will feature all 13 slides, so you should be able to print that out. Hope this helps and we appreciate your interest.

-Gabriel Perna, managing editor

Gabriel S @

Wow thanks for teaching me all this! What a revelation the 13 slides are!!


R @

Why not put your full name so people can see who exactly throws insults like this? I bet you're a gem to work with!

Dan @

I used to be able to read these articles and go through the slides but one day it just stopped working. Have thought all along it was my computer but obviously not if others have the same issue. Maybe someone needs to reevaluate their site so we can access this information.

Tonia @

Tonia - sorry you are having trouble accessing the slideshow. Can you let me know what browser you are using? We have had some complain they aren't able to click the arrows or the thumbnails to browse through the slide and I'd like to figure out why.

Gabriel Perna, managing editor

Gabriel S @

Hover your mouse over the "slide" - this will reveal left/right arrows, and you can then navigate to see the following slides

Richard @

Thanks for your comment and assistance with others.

Gabriel S Perna, managing editor

Gabriel S @

This are very common signals. However in the hospital the physician, PA, or NP does not get to be around when the patients' aggressive performances are at their best. The bedside nurse needs a protocol to enable a tapering of meds before discharge home. Especially IV!!

Leisa @

I agree. In one study I read, nurses are more often the victims of violence than doctors. The same happens in the out-patient setting as well. I have had to step in when I have seen patients get aggressive with my staff. We need better protocols. Nurses shouldn't be thrown to the task of dealing with aggressive patients.

Linda @

This publication always has this issue. I delete their emails now because the article is never complete or it can't be found! Their articles do catch my attention but I don't have a lot of luck finding them.

Phyllis @

HI Phyllis - are you having trouble navigating the slideshow? We will put a link to the PDF on this - if you can't navigate through the slideshow. Sorry about your trouble. If there is other feedback, you'd like to offer, feel free to email editor@physicianspractice.com


-Gabriel Perna, managing editor

Gabriel S @

Add new comment

Loading comments...

By clicking Accept, you agree to become a member of the UBM Medica Community.