Tips on how NOT to appear like a Drug seeker

mwboswell · Dec 4, 2008

I am looking for some advise, my sister IMO is an addict. She goes to ER all the time and different doctors all the time. She goes to ER for migraines, then it was back pain, then kidney stones, now it's all 3! She was going twice a week to ER sometimes even twice a day. She has insurance with a co-pay so it's cheap for her to go. My husband and I checked how many pills she was taking while she lived with us. It was at least 15 hydrocodone a day, and and sometimes perocet on top of that and an ER visit for a shot. In 2 weeks she went to 5 or 6 doctors and 2 ER. One ER doctor gave her 30 hydrocodone and 15 percocet and a shot all in one visit. Another doctor gave her 56 hydrocodone (why not 60?) is there a limit on how many they can give? Anyway when confronted she denied everything and we never showed her the proof.
Is there anything we can do since she is in denial? Call the hospitals maybe? She goes to different doctors so we can't call them. One of the last times she went for a shot they gave her the shot, she got in her car drove to get her pills and was back before her ride showed up to get her.
We are very very worried about her, but she is an adult. Is there anything we can do?

Great question and good of you for being so astute and observant.

Absolutely there is something you can do.....

I understand your concerns about pt privacy and information sharing, however, know this, if two or more physician's/hospital's are providing her care, they are NOT violating her privacy to discuss between them. They are all providing care to the same patient and each of them has a relationship with that pt. Each individual Dr/Pt relationship is NOT exclusive. However, it would require the pt's permission to share information. But I would think if you (for example) told her Primary MD (start there) that you had concerns and observations, then I think the Primary MD would PRUDENTLY ask the pt permission to get any and all records from these other providers that you mention. If the pt refused to give permission to get records sent, I would hope the MD would consider dismissing her from the practice as she isn't giving a "full and complete medical history".

This should be repeated with each hospital. I would suggest that you write a "letter of concern" to the medical director of each ER and I assure you, they would at least read it and review it. Trust me, ER's are VERY concerned (sometimes it doesn't seem so) about over Rx'ing of narcs and 'doctor/hospital" shopping around.

It is NOT a violation of privacy for one provider to contact another to simply ask if said pt is a patient of theirs. Further information would require permission. (of course Mental health laws are a little fuzzy here; like if you call your state psych hospital, they may/or may not be able to tell you if so-and-so was a pt or not due to specialized mental health legislation).

Finally, you could, (I think) ask that the pt's primary MD "make an appointment" with the pt and you and your family happen to "just show up also", with the whole goal being for you and the pt, (in front of the Dr) to have an "intervention" or discussion about everyone's concerns. Depending on how this goes, (IE if it goes "bad') the pt might get dismissed from the practice as well.

I hope this helps.

Realize that I am NOT familiar with ALL rules and regs in every state and I'm just giving you some Ideas to consider.

I think your SAFEST bet, would be to discuss this with YOUR licensed health care provider during an office visit; and ask them how they recommend you proceed. At least they are aware of the particulars in your state/region/locale.

Please let us know if you get something to work out on this.

good luck!

**canoehead, BSN, RN** · Dec 5, 2008

I agree. Write a letter with your concerns and observations and send a copy to her PCP and each ER.

UnitSec · Dec 5, 2008

You give the doctors too much credit. Don't you know that the first thing they are taught is that all patients are liars and are seeking to get the doctors ruined by forcing them all to prescribe pain meds?
The other night, I was in sudden, excruciating pain, called my PMD, got his idiot colleague after 3 calls and waiting for more than an hour for him to call back. He asked what was wrong, I told him agonizing pain. Did he take a history? Did he recommend alternatives? Did he prescribe a small amount of meds, just to get me through the night? No. His response was, without so much as determining the source of the agonizing pain, I can't give pain meds in the middle of the night.

You expected him to give you pain meds for "sudden, excruciating pain?"

No doc I've ever worked with would have just written a script for a patient they had never seen, and who had unexplained pain. I think that no doctor worth their salt would do so. Not only does it put their license in jeopardy, but it's really bad medicine. Perhaps he should have recommended that you go to the ER to find out why you had such a sudden onset of pain, but I suspect that after he said "no" you didn't care what else he had to say.

ACRN06 · Dec 5, 2008

The mere title of this thread makes me want to hurl... and why the F has it made it 14 pages long?!? I can't even stand to read the whole thing...

are all you other nurses seriously giving up our ways of knowing when someone's drug seeking?!

The OP isn't even a nurse

Why the F are they even allowed to be on this website?!?

Ridiculous...

Why don't we just start a thread of "How to fool the nurse!"

sweetsounds · Dec 6, 2008

Heh, heh, heh. Does make you wonder a little.

Blee O'Myacin, BSN, RN · Dec 6, 2008

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 increases my risk of Kidney stones. Hopefully this will never happen, but if it does and I need to present to the ED, what advice (on behaviour and what to say for example) can people here give me so I don't get wronly perceived as a Drug seeker. Taking into consideration I am a former Heroin addict, sensitive to NSAIDS and can't take Ibuprofen or Aspirin type medications due to asthma.

Reminds me of a patient with lots of new track marks asking me for tips on venipuncture. (Guess she wasn't having much success with it given the location and amount...)

I don't doubt that even drug addicts get physically ill. But learned behaviors to not be perceived as a seeker? That's like wearing a neon sign saying "give me some of that de-lilah in my tunnelled PICC line, 4mg undiluted!"

TraumaNurseRN · Dec 9, 2008

I think nonmedical posters in this website is wrong. This title tells it all.

TraumaNurseRN · Dec 9, 2008

Even so Val, the ER is the place people end up because frequently even chronic pain involves breakthru, and that is an acute condition best managed in the emergency setting.
My advice to the OP, talk with your doctor about the best course of treatment SHOULD YOU HAVE TO go to the ER. Carry a letter with you from him/her that says "This pt. is under my care , please give med X, Y, and Z and call me if you have any questions or concerns." You will find that many doctors appreciate this (both ER and private practice). This will expedite your care and allow your ER doc to know that YES, your PCP is aware and that he/she can be contacted at any time. This can go a long way in avoiding the perception that you are a "drug seeker".
vamedic4
Good luck!!!!

If the PCP is going to write a note for the patient to go to the ED, they can certainly write the script themselves. :confused:

traumagirll99 · Dec 10, 2008

The mere title of this thread makes me want to hurl... and why the F has it made it 14 pages long?!? I can't even stand to read the whole thing...
are all you other nurses seriously giving up our ways of knowing when someone's drug seeking?!
The OP isn't even a nurse
Why the F are they even allowed to be on this website?!?
Ridiculous...
Why don't we just start a thread of "How to fool the nurse!"

I could not agree more with you. I have visited this site for few years and am always amazed at the # of nonnursing people on this site; and how those nonnursing people are always ready and loaded with their "I was treated so badly at er/icu/or/fill in the blank."

mmutk, BSN, RN, EMT-I · Dec 10, 2008

It never amazes me anymore how there are some nurses who can be the worst drug seekers I know. And such a pain to deal with in the ER.

TraumaNurseRN · Dec 11, 2008

Drug-seekers whether nurses, or anyone else drive me nuts with their entitlement mentality. I have chronic pain and deal with it, work with it everyday...and it never ceases to amaze me their ignorant ways of trying to fool the nurse and doctor...and for the OP (nonmedical/non-nursing) to post with such a question makes me believe they have drug seeker written all over them. Discusting. :twocents:

msnobodycares · Mar 17, 2011

There is no way that anyone isnt seen as a drug seeker. Your arm could be half chopped off and they will think you are looking for drugs to have a party. Its just sick. All this effort to keep some junkies from getting their kicks. While people suffer and if they complain, they get lumped in as a SEEKER for complaining! Its like the Salem witch trials...float you in water until you drown and if you sink, you were guilty. If you floated, you were innocent...but still dead. Its kinda like that kind of thinking...