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?
13 Red flags your patient is a drug seeker
Red flag 1
Your patient comes from a town where few other patients come from, far from your office.
Maybe even across state lines.
Red flag 2
Your patient has seen many physicians in a short period of time.
Red flag 3
Your patient comes carrying records that are from several years ago.
Your patient has been carrying these same records around to many different physicians to get a pain prescription.
Red flag 4
Your patient uses multiple pharmacies.
Red flag 5
Your patient claims an allergy to all pain medications except the one she/he/they is seeking.
Red flag 6
Your patient comes telling you the dose, the medication and the quantity he/she/they wants. Your patient doesn’t want to listen to anything you have to say.
Red flag 7
Your patient isn’t willing to consider any other treatments. Patients who are truly in pain want it to stop. They are willing to try most therapies that would make that happen.
A drug seeker only wants the medication.
Red flag 8
Your patient calls when the office is closing or right before the weekend or a holiday requesting a prescription.
Red flag 9
Your patient lies or his/her/their story doesn’t make sense.
It is imperative to take a detailed history. Often, there are inconsistencies in a fictitious story.
Red flag 10
Your patient exaggerates his/her/their symptoms.
A patient can walk into the office fine but hold a hurting body part or start moaning in pain once in your presence. Don’t be fooled by tears, either. Many drug seekers are convincing actors.
Red flag 11
Your patient gets aggressive when you bring up the idea of trying different medications.
Red flag 12
Your patient gives false information, such as a fake address or disconnected phone number.
Red flag 13
Your patient is taking multiple controlled substances.
