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.