Tips on how NOT to appear like a Drug seeker - page 6

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... Read More

  1. Visit  leelinn profile page
    0
    Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.
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  3. Visit  EDValerieRN profile page
    0
    First off, yes. If you are a drug seeker, and you want medication, just be honest. Don't fake chest pain and make me do a full cardiac workup when really you only wanted to get high. If it were my personal choice, I would not give you the medication... however, it depends on the MD working. One is known as the "candy man" and gives anyone whatever they want. Most of them use common sense.

    LeeLin: drug seeking is a real problem. Sure, addicts have real pain. Sure, pain meds were meant for people in pain. That doesn't mean that we should turn a blind eye and assume that everyone asking for dilaudid "slam it in" is really in pain. Not all people are. Some of them want a fix. There is no "soap box" about it... it's just a fact. And as a prudent nurse, you should be aware of how many rx's you have given a patient this week for a narc. Have one overdose on the prescriptions you gave him, and you'll see there is a valid reason we worry about it.

    This is coming for a nurse who will give the benefit of the doubt 99% of the time, and advocate for pain meds. I am not, however, stupid... and I will remember those patients who take me for it.
    Last edit by EDValerieRN on Sep 1, '06
  4. Visit  RunnerRN profile page
    0
    Quote from leelinn
    Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.
    I'm going to take a wild guess that you don't work in the ER/any area of first response. Drug seeking is a big problem in many EDs, and it takes up quite a bit of time and resources. How would you feel if you were in my ER having chest pain that was actually a cardiac event. But I'm in the next room over doing a full cardiac workup on the drug seeker who SAYS he has chest pain, but really just wants some dilaudid/demerol. So yes, people who are really having pain should be medicated, but we can't just go around pushing dilaudid on everyone who says he/she has TOE pain (and yes, I have had people with toe pain asking for heavy duty narcs).
    You say we should get off our soapboxes....it sounds like you're on yours and having a great time judging the rest of us.
  5. Visit  TazziRN profile page
    0
    Quote from leelinn
    Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.
    Really? Did you know that if physicians knowingly contribute to an addict's needs by giving more narcotics, that he can be censured? This is why it's such a fine line, trying to determine who is truly in pain and who is just looking for a high. Do I have sympathy for the addict who just needs a fix? Yes. Will I "help" him by giving him a shot of demerol or morphine? Not without an argument.
  6. Visit  country mom profile page
    1
    Quote from WillowBrook
    II do find it a bit perplexing as to why anyone would try and scam drugs from an ED. I know people do it, but it just seems to be to be an awful lot of trouble and messing around for possibly no gain.
    In my experience, I think that sometimes when people get their drugs from the ER or physician's office as opposed to a "dealer", they feel that it somehow legitimizes their drug use. It's almost like it's where "respectable" people go to get their fix. So many people are seeking a chemical solution to a deep, spiritual hurt that they have and often manifests as physical pain. Those are the people who walk out the door and I feel like I haven't done a thing for them.
    UnitSec likes this.
  7. Visit  West_Coast_Ken profile page
    0
    Quote from traumaRUs
    I truly am very sorry for patients that have not received adequate pain meds.
    Amen. I'd rather a drug seeker get meds than a pt who is in real pain not get meds. Get my point? Which is worse? Please say the latter...

    This whole issue really is a sad commentary on our (USA, in my case) "War On Drugs" society. Who's right is it to deny a truly in need pt pain meds because there are those who should not receive them?

    One of my clinical rotations in the ER a pt was returning for a check of his sutured finger. Nothing major, right? It was a follow up in a small rural hospital. As I did his assessment I asked "On a scale of 1 to..." I didn't even finish and pt said "10!". I finished "...to 10 how would you rate your pain?" He again said "10!" BP, temp, pulse, etc all a-okay. There's no way this guy was telling the truth--period. I documented his reply "10/10" as well as mentioned this to the RN supervisor. pt left with Rx for 10 of something (I forget what it was)...

    Point is, I'd rather see this guy get his meds than someone leave in pain any day, any time. If someone wants to fight the war on drugs, please don't deny pts pain meds. Sign up for the DEA.

    Regards,

    Ken

    P.S. I landed a preceptorship in an ED so I'm sure I'll get to see much more of the "is he or she faking or not" question.
  8. Visit  TazziRN profile page
    1
    Quote from West_Coast_Ken
    One of my clinical rotations in the ER a pt was returning for a check of his sutured finger. Nothing major, right? It was a follow up in a small rural hospital. As I did his assessment I asked "On a scale of 1 to..." I didn't even finish and pt said "10!". I finished "...to 10 how would you rate your pain?" He again said "10!" BP, temp, pulse, etc all a-okay. There's no way this guy was telling the truth--period. I documented his reply "10/10" as well as mentioned this to the RN supervisor. pt left with Rx for 10 of something (I forget what it was)...
    And that is a good way to handle it.....give the pt a script for enough to get by but not enough to do anything else with.

    And congrats on your preceptorship!!
    mrsmamabear2002 likes this.
  9. Visit  fleur-de-lis profile page
    0
    I'm just a measly student, so please don't take this post the wrong way - I have already seen that what they teach us is not always how it works in the real world!

    That said, isn't pain control a right, and mandated by JCAHO? We were taught that even the people who ARE drug addicts have a right to pain relief, and that nurses are obligated to take the patient's word for it. "Pain is whatever the pt. says it is" was preached to us ad nauseum!

    Just curious how this plays out in real life. If a patient is believed to be a drug seeker, and is denied pain control by physician/nurse/staff. could the facility be subject to problems with JCAHO if the patient is wise enough to complain?
  10. Visit  gauge14iv profile page
    0
    Yes - but by the same token - the staff could be prosecuted for contributing to a drug problem too...

    right from the state of Texas drug diversion programs website (other states and the DEA have similar guidelines)

    http://www.txdps.state.tx.us/crimina.../diversion.htm
  11. Visit  fleur-de-lis profile page
    0
    Wow - that really puts us in a bad position! One of the "Don'ts" for HC providers on that site is ""Take their word for it" when you are suspicious of their medical condition or behavior." That directly contradicts what our profs say and (from my understanding) what JCAHO says! Thanks for the info Gauge!
  12. Visit  onlyanrn profile page
    0
    I agree that only someone who is seeking would worry about how not to look like she is seeking. If you are truly in pain, you are not going to care what others think of you or how you apepar.
  13. Visit  ERNP profile page
    0
    Quote from WillowBrook

    Question for people out of interest....would you have slightly more respect for a drug seeker if they just came out and honestly said that they were in withdrawal and needed something to help them out?
    Respect might not be the word I would be looking for, but it certainly does take the mystery out of the equation to have an actual admission of addiction or physical dependence. I appreciate the honesty.

    Sometimes withdrawal will produce life threatening symptoms. I have an interest in preventing the life threatening symptoms. I have given a one time dose to people that finally fessed up to being in withdrawal. Sometimes even when you know they are in withdrawal, they won't admit it. Leaving me to do a million dollar workup when all they really needed ot stop their symptoms was a dose of narcotics.

    At the same time I give the one time dose I confront them. I tell them what I think their symptoms are from and most will then admit it. I am probably quite stern, but I might be the wake up call that keeps them from dying on their next OD. I offer to have drug rehab come and talk to them. Most of the time they aren't interested. But every once in a while someone will come back later and ask to speak to someone at a drug rehab. But like WillowBrook said, getting clean is the easy part. Some make it to stay clean and some don't.
  14. Visit  ERNP profile page
    0
    Quote from leelinn
    Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.
    Indiscriminate prescribing of narcotics is what got a lot of people in the predicament that leads them to inappropriately utilize the ER to obtain drugs.

    If I am inappropriately prescribing narcotics then I have to worry about the state board, the DEA, the state drug agency, as well as the other providers in my community. Providers in my area have lost the privilege to prescribe narcotics due to inappropriate prescribing behaviors.

    No one is advocating letting people in severe pain suffer. Not even if they have been in 100 times in the last year and perceived to be a drug seeker. What is being advocated here is the appropriate use of the appropriate medication for the injury or illness in question. Sometimes there is a need for strong medications and sometimes not.


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