Tips on how NOT to appear like a Drug seeker - page 4

by WillowBrook

66,352 Views | 150 Comments

Having read through some of the threads regarding Drug seekers in the Emergency Department I must admit I now feel quite nervous of being misperceived in this way. I take medication which causes some urinary retention and... Read More


  1. 1
    Quote from stevielynn

    Plus, even "junkies" can get kidney stones . . . .

    steph
    Yes thank you. I have been fortunate enough since my whole addiction with Heroin experience and overcoming it, to (most of the time) receive excellent care by Medical Practioners and/or ED staff; however there was one time (which I discussed at length in a thread in Pain Management) when a nurse seemed to go out of her way to be rude to me after a Doctor ordered Fentanyl for pain relief caused by my falling 8-10 metres through a roof and severely jarring my spine. I mean come on now, so what if I used to be a Heroin addict...I have just fallen through a roof, injured my back I think under the cirumstances "drug seeking" can generally be ruled out.

    It is because of these past experiences, as well as what I have read on here that I am concerned with making sure I don't get this "drug seeker" reputation if I ever do have to present to the ER with severe pain (for whatever reason). I think Vamedics advice about carrying a letter from my GP is excellent and I will certainly see about organising that during my next appointment.

    Just for interests sake, regarding how painful Bornholms is here is what a couple of patients have had to say re the severity of the pain.

    It appeared as a stabbing pain in my right side so severe that I thought I was being stabbed, I screamed out in pain!(Much worse than childbirth!)

    The pain I experienced was the worst I have known. Comparing this with the delivery(forceps)of second child weighing 10lbs. Removal of my gall bladder - gall stones.Passing a kidney stone.
    Last edit by WillowBrook on Aug 30, '06
    tsalagicara likes this.
  2. 1
    Quote from WillowBrook

    Just for interests sake, regarding how painful Bornholms is here is what a couple of patients have had to say re the severity of the pain.

    It appeared as a stabbing pain in my right side so severe that I thought I was being stabbed, I screamed out in pain!(Much worse than childbirth!)

    The pain I experienced was the worst I have known. Comparing this with the delivery(forceps)of second child weighing 10lbs. Removal of my gall bladder - gall stones.Passing a kidney stone.
    :wink2: My pain scale for myself is if it doesn't hurt as much as childbirth, it doesn't hurt.


    Actually to be honest, I do work with a nurse who is very judgmental about ER patients and it bugs me to no end so obviously that is where I'm coming from. Just snap judgments and negative remarks before knowing anything about a patient. That is not fair, or professional.

    steph
    tsalagicara likes this.
  3. 0
    Just curious, did your significant other accompany you to the ER on this particular day?? I'd have had every member of the hospital's management team in there apologizing for your treatment...
    vamedic4
    Quote from WillowBrook
    Oh really? Reading through some of the threads on here about the assumptions that are sometimes made regarding who is and who isn't a Drug seeker, as well as hearing testimony from others who have mistakenly labelled as "drug seeking" and mistreated because of that fact, along with the fact that I have personally experienced being mislabelled as a "just a junkie looking for a fix" by ER staff, I seriously beg to differ with you on this point.

    In 1997 I presented in severe pain to a local Emergeny Dept. I was sent there directly from an after hours medical service and was suspected of having a Pneumothorax. I had been experiencing severe headaches and earaches all that day, by night time I was vomiting and being wracked by extremely painful spasms all through my neck, back and stomach. I have never experienced anything more painful in my life so far, and that includes crush injuries and fractures to my foot and post Laparoscopy/Hysteroscopy pain, I was literally screaming with pain and I could not help myself. When I got to the ED right from the start I was treated badly. The admissions Nurse berated me for not being able to say more than 2 words at once through the pain to give my details properly, the Nurse who was assigned to look after me once I was admitted was very short and abrupt with me, at one point she lowered the back of the bed down and it set off a series of extremely painful spasms, so she quite roughly shoved the bed back up to a more upright postion and walked off with a huffy "there hope your happy" comment thrown back at me. At all times, whilst I screamed and cried and begged for pain relief, I was made to feel as if I was just a huge inconvenience and annoyance to them. When the X-ray came back clear for Pneumothorax, do you know what they did?? The Nurses and The Doctor who were supposed to be looking after me went and stood in full view of me drinking coffee, laughing, pointing, rolling their eyes in my direction and making comments about "junkies looking for a fix". I was discharged with a valium and one Panadeine Forte tablet. I half squat walked, half crawled out of that ED, still in excruitiating pain and still vomiting. 2 weeks later it was finally realised that I had Bornholms Disease.

    So after an experience like this please do not try and tell me that only a Drug Seeker should be worried about being seen as such.
  4. 2
    I know none of the comments were directed at me, but I feel as though I should defend myself here. Experienced AND CARING ER nurses and doctors can tell when someone is in genuine pain versus looking for a fix. Usually.

    And as for the suggestion about "Don't say that only Dilaudid works for you"? That also falls under the "genuine pain" argument. People who have chronic pain do know what works best for them, but those who are not and are just in for a fix are also often "allergic" to every other med that should be tried first.

    To the poster with Bornholm's, I am so sorry for your experience and I wish I'd been your nurse. I would have fought for you.
    mrsmamabear2002 and canoehead like this.
  5. 0
    I truly am very sorry for patients that have not received adequate pain meds.
  6. 0
    Quote from TazziRN
    I know none of the comments were directed at me, but I feel as though I should defend myself here. Experienced AND CARING ER nurses and doctors can tell when someone is in genuine pain versus looking for a fix. Usually.

    And as for the suggestion about "Don't say that only Dilaudid works for you"? That also falls under the "genuine pain" argument. People who have chronic pain do know what works best for them, but those who are not and are just in for a fix are also often "allergic" to every other med that should be tried first.

    To the poster with Bornholm's, I am so sorry for your experience and I wish I'd been your nurse. I would have fought for you.

    Tazzi is correct about the sufferers of chronic pain, but it's my experience that many docs when you present to the ER will ask a patient who has chronic pain "What works best for you"...this added to the letter I mentioned in an earlier post helps to clear up any confusion the doc may have.


    vamedic4
    I don't want to go outside
  7. 0
    I have suffered migraines for the past 10 or so years. My last experience of having to resort to going to the ER for relief felt like a disaster. I knew I needed to be up for work in a few hours and couldn't get to sleep d/t the usual visual disturbances I get.

    During triage, the nurse actually said, it's 3 in the morning, what are you doing in here with just a headache. Is it really a migraine or are you just calling it a migraine. Why are you coming in now if you had it for three weeks. Only the final question is forgivable, though the tone of her voice isn't. I knew it was a migraine since it was all of the same symptoms as the last headache that got me a dx of having migraines. All I wanted at that point was to get rid of the flashing lights and get to sleep. I even told them what worked the last time, compazine timed IV push. Nurse took off in a huff. I don't remember actually seeing a doctor that night, I just remember the nurse coming back with a tramadol IM and a script for Ultram. Even after complaining that the flashing was still there.

    Then the most amazing thing happened when I asked to use the phone to call for my ride. I asked them to dial an in house extension and suddenly everyone fell over themselves to be accommodating. Like oh here use this phone.

    Now that I am on Depakote for the migraines, and Imitrex for the rare ones that get through, I'm treated with plenty of tender care when I say I have a migraine. I also carry a list of allergies and meds since half the time I forget to say all of them and only tell the ones that I think are relavant. I include dosages and freqency of my meds and the reactions of of my allergies. After that, the MD/NP can make the decisions.
  8. 0
    Quote from emeraldjay
    Why are you coming in now if you had it for three weeks.
    I ask this kind of question a lot, because I often get more information this way. By asking this question I find out that there are new symptoms, or a worsening of the symptoms.
  9. 0
    Quote from ERNP
    Don't run out of chronic pain meds on Friday at 5pm. Even if you "called the office and they didn't call you back". Plan ahead!! Call them before Friday when you know you are getting low. If it is time to have a refill they will usually get one called in for you. If you are too early they will assume you have either diverted your meds or not taken them as directed.

    Don't call administration to complain that you didn't get your drug of choice.

    Don't throw your soda on the floor and go into full "writhe mode" as soon as you see me walking into your room. I have already been past your room and had found you resting comfortably. I don't hand out awards based on performance, like the Emmys.

    Don't call back 2 hours later requesting a new prescription because you lost, your dog ate, or you washed the old one.

    Growing new allergies during the discharge process is a dead giveaway. "What did you give me?" "Ultram". "Im allergic to Ultram", "That wasn't listed as an allergy nor did you mention it earlier in our interview... you remember when I asked.... "Are you allergic to any medications?" Were you not allergic to it then?

    I could go on and on... there is so much of this in our community.
    HA HA HA HA! You are describing so many of my pain management patients. I see this crap all the time, they'll even come in with a police report stating someone robbed them and took that meds! I just write them a script for a clonidine taper and tell them this will keep them out of withdrawal until they can get another refill. I just discharged someone today because I suspected she was abusing her meds...turned out I was right on the money...she tested positive for benzo's and oxycodone, but she was only being prescribed methadone. When she told me that she was getting the other meds from another doc, I showed her the contract she signed stating that WE were the only ones allowed to prescribe a controlled substance!!! She has 45 days to find another physician. I LOVE busting the losers!
  10. 0
    A pain contract is very important for chronic pain sufferers. This provides a double-purpose system of checks and balances: the patient receives the needed meds and the provider stays out of trouble also.

    IL is going to be going online for patients who utilize Medicaid. This will help to weed out those folks that fill meds from multiple providers.

    I did have an enterprising young man who had Medicaid but who would pay cash for his narcotic scripts, thus avoiding the computer because Medicaid didn't pay for it. However, the pharmacy called me.


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