Drug Seeker Antics and Dramas

  1. They are an everyday event in almost every ER around the country. What is the drug of choice in your area? I've noticed around here it is Vicodin.

    Our latest little treasure was an ex RN who was a daily event in our ER. She would come in complaining of backpaid and demand a shot of demerol and a script for Vicodin. Her MD's (She had many over the years) refused to see her. We kept a lot of documentation on her antics in order to confront her with her possible little problem. Well the big day came, she didn't take it real well. She stormed out of the ER, went around the building, came in thru the main lobby and straight to a pay phone. She called in a bomb threat to the ER. The police tracked her down, they could hear the hospital pages in the background. She is now in a facility.
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  2. 91 Comments

  3. by   ang75
    As always, Vicodin and Xanax. For those really over zealous, the choice is Demerol as they are ALWAYS allergic to everything else. The prob is so bad here that they put a drug&alcohol detox center in town that is always full. Ahhh, the joys of nursing.

    By the way, don't you love the fake vomit attempts for the "migrainers"? Now, don't get me wrong. I know there really are people who do get true migraines, I am one of them. But Imitrex and some Benadryl always does just fine.
  4. by   RainbowSkye
    Drug seeking in the ER has really been troubling me lately, to the point that I'm considering leaving the ER (to where, I'm not sure). I've been an ER nurse for over twenty-five years, so you know things have gotten bad.

    I work in a rural ER, and some days nearly 100% of the patients seen in our ER are drug seeking. To those pain management folks who are wondering how I know, please just trust that I never want someone to be in pain. But there is a difference between a drug seeker and a pain relief seeker (a little aside here, I do believe the drug seekers are seeking pain relief, but it's a pain of the soul or the psyche or sometimes just the pocketbook).

    Anyhow, I don't want to pick that open sore and open up comments of how ER nurses love to make fun of their patients and enjoy seeing them suffer. I just want to say that endless interactions with the poor folks abusing drugs (or selling them, and sometimes both) is exhausting. And I just don't know how much longer I want to take it.
  5. by   SWFlorida
    We've even had pts who will try to make copies of scripts on their scanners and get them filled at all of the pharmacies in the county. Some will travel over several countys. Huge business in these drugs on the street.
  6. by   z's playa
    :chuckle :chuckle Here we go. I get migraines and Imitrex and Maxeran do wonders....however not all the time. Every 4 months or so I get one that won't go away. After 72 hours, status migrainous, and after about 6 Naprosyn, Tylenols, 2 Imitrex and the dark room full of ice....I haul a*** to the ER. Here I feel like I'm getting the "looks". Even armed with my letter from my PCP that states narcotics are sometimes needed, I follow up every 3 months and I'm on Propranolol daily. I'm very happy that you get relief every time you take your rescue meds, but not everyone does. Always.

    And believe me it is HELL going to the ER for that complaint. And I do dry heave as well since I'm always dry as a bone by the time I get there. 180/90, 37.3 Total pain

    I get the dark room upon arrival, a bolus of saline, 30 Torodol, 10 Maxeran, 50 x 3 Demerol. (over a period of 6 hours mind you.)

    Severe adverse reactions with Stemetil, DHE and Decadron.

    Sucks.
    Last edit by z's playa on May 31, '04
  7. by   veetach
    Our patients drug of choice is Percocet. We even have those who take the script to the pharmacy and try to write a "1" in front of the amount so it reads "112" or "118". Like the pharmacists would buy that.
  8. by   z's playa
    Quote from veetach
    Our patients drug of choice is Percocet. We even have those who take the script to the pharmacy and try to write a "1" in front of the amount so it reads "112" or "118". Like the pharmacists would buy that.
    Word. Like where are YOU going? Tibet? No pharmacies there? Our pharmacies always call the minute we get there. Who cares if its 3 am.
  9. by   SWFlorida
    I got a call from a pharmacy one night. A pt presented to the counter with a script for "a pound of mofine" (note spelling) Of course we didn't rx this..... The pharmacist laughed all the way till the cops showed up.
  10. by   Stitchie
    Quote from SWFlorida
    I got a call from a pharmacy one night. A pt presented to the counter with a script for "a pound of mofine" (note spelling) Of course we didn't rx this..... The pharmacist laughed all the way till the cops showed up.
    Classic. Can you frame that one? It deserves it's own hall of fame...especially the spelling.
  11. by   mariedoreen
    Quote from z's playa
    :chuckle :chuckle Here we go. I get migraines and Imitrex and Maxeran do wonders....however not all the time. Every 4 months or so I get one that won't go away. After 72 hours, status migrainous, and after about 6 Naprosyn, Tylenols, 2 Imitrex and the dark room full of ice....I haul a*** to the ER. Here I feel like I'm getting the "looks". Even armed with my letter from my PCP that states narcotics are sometimes needed, I follow up every 3 months and I'm on Propranolol daily. I'm very happy that you get relief every time you take your rescue meds, but not everyone does. Always.

    And believe me it is HELL going to the ER for that complaint. And I do dry heave as well since I'm always dry as a bone by the time I get there. 180/90, 37.3 Total pain

    I get the dark room upon arrival, a bolus of saline, 30 Torodol, 10 Maxeran, 50 x 3 Demerol. (over a period of 6 hours mind you.)

    Severe adverse reactions with Stemetil, DHE and Decadron.

    Sucks.
    Just from working in a pharmacy for several years I cannot tell you how many horror stories I have heard from migraine sufferers. People whose migraine are lasting days with no relief. Especially if they don't get started on their meds right away. Because mine are usually alleviated with sleep and Naproxen Sodium I've often doubted that they're true migraines, but the one thing I've learned is that there is no typical migraine sufferer. Yes, there are a lot of abusers of the system, but unfortunately there are also a lot of those who go unbelieved because of those abusers. I'm so sorry you have to go through that on top of your pain.
  12. by   PA-C in Texas
    I would just like to say a few words about the agonists/antagonists that are available. I have found that they are very effective drugs. If there are migraines that won't respond to the 5-HT agonists, ergotamines, toradol, and either Talwin, Nubain, or Stadol, it is time for a head CT.

    Of course the addicts won't care for the Stadol NS that you prescribe, but perhaps that will dissuade them from using the ED as their supplier.
  13. by   teeituptom
    Wrong , they seem to love the stadol nasal sprays

    They can take hits in their nares while driving down the road

    we get them begging for stadol NS

    helps their rush hour commuteing, I guess

    who cares about heavy traffuc when stoned on Stadol NS
  14. by   traumaRUs
    This is one place where ER case managers can help. One of our primary jobs was to come up with care plans (with the PCP and pt involved of course) and get on a game plan. One of the neurologists in my area has a migraine clinic and puts those pts on a solid regimen of beta-blockers and other headache abortive meds, then gives them addtl meds for break-through pain and if all else fails, they come to the ER. We are very sparing with our narcs but I always encourage the ER docs to contact this neurologist or on-call doc to ensure that we are in compliance with the care plan. This has cut down drastically the number of ER visits for this population. I do want to add to that this is only for pts having their "typical migraine pain". The education these pts get is very good and they know to come in and say that this is their "typical h/a" otherwise a CT/LP is in their future.

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