Tips on how NOT to appear like a Drug seeker

Specialties Emergency

Published

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.

Specializes in RN, Cardiac Step Down/Tele Unit.

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?

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Specializes in ICU, ER, HH, NICU, now FNP.

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/criminal_law_enforcement/narcotics/pages/diversion.htm

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Specializes in RN, Cardiac Step Down/Tele Unit.

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!

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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.

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Specializes in ER, critical care.

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.

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Specializes in ER, critical care.
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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Specializes in ER, critical care.

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!

quote]

A right?? Healthcare in itself isn't even a right!! It isn't in the bill of rights or the constitution. Is providing care morally and ethically responsible for a civilized society, yes. But not a one of those "inalienable rights" with which man was "endowed by his creator".

Imagine this.... We hold these truths to be self evident, that all men are created equal... endowed by their creator with certain inalienable rights to include life, liberty, the pursuit of happiness, a prescription for Percocet, and a shot of dilaudid".

I have often thought of JCAHO's role in the demise of healthcare in general. They have created more havoc and more paperwork than any one organization has a right to create. But they still can't dictate provider practice. Maybe that is in the works for next year.

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I have to admit it but I feel for the people with mental illnesses coming in with pain. They automatically are deemed either neurotic or drug seeking. 10 years ago I was misdiagnosed with a mental illness and put on a whole slew of drugs. I developed severe abdominal pan while at work (I was and still am an RN) The pain was a 50/10 when I moved. As long as I stayed still I was fine with no pain. I had to be picked up from a chair and put on a stretcher taken by ambulance then placed on an ER stretcher. Needless to say I was not handled gently and I screamed in pain. A resident came in told me to stop sreaming then proceeded to ask me what illegal drugs I take and how much alcohol I drink. I told him I work in a jail get random drug tested and I do not drink. He drew blood and refused to give me anything for pain. He then sent me to xray for a sitting and standing KUB. needless to say I could not do it so the Xray tech "helped" and spun me into a dangling position (I was only 85lb) She recieved a reflexive punch in the arm. I was so embarrassed but the tech told me I had nothing to be sorry for it was her fault the resident told her to do it because he thought I was faking. I was diagnosed with pancreatitis with a lipase level off the charts. The resident came into my room and said "now tell the truth how much do you drink" I told him I do not drink he then said well you have severe pancreatitis I said nice how else do you get it he said gallstones. I was admitted to the ICU and almost died. I recovered and had 2 surgeries to remove all the stones (they filled 2 urine cups. When I recuperated I made a date with the medical director and had a meeting with the resident and presented him with the stones. He humbled and said when he saw al the meds I was on he immediately felt I was faking and a drug seeler. Sad to say but I got that whereever I went. Thankful to say I stopped the meds on my own 8 years ago and have had no problem and continue to work as an RN. No one has since ever labled me a drugseeker or neurotic. Go figure

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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.

Well you'd think so wouldn't you (about not caring how you appear) and yes if I am ever in severe pain and need to present to the ER the foremost thing on my mind isn't going to be "do I look like a drugseeker", it's going to be "help me stop this pain please". I did not pose the original questiont o get "tips" on how to scam drugs from a hospital, I have absolutely no need to do this seeing as a) I am a former Drug Addict who has been completely clean for 4 years b) even if I was still an addict I already know which local Doctors I can go to for "help" c) If I was still an addict it is far easier for me to just call up a local dealer to get a fix.

As for why I did pose the original question, well I think anybody who reads these boards and hears how people are so quick to pass judgement on who is a drug seeker and who is legit (not saying everybody but there is a certain element here) and then read about other peoples bad experiences as being mistaken for a drug seeker, would be extremely naive to think that they don't have to worry about being perceived as a drug seeker.

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Specializes in ICU, ER, HH, NICU, now FNP.

I am just a little concerned that this is all available for anyone who is not a nurse who stumbles across this board to read however...

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http://www.painreliefnetwork.org/
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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

By doing a search on Google, about "tips" for getting a fix, this thread wasn't showing up on the first 25 pages of results. Actually nothing allnurses related, either.

And, let's see here, how many threads are on here that contain posts that reference people/pts. who were drug seekers, in detail???

In that 5 minutes search, there were sites listed, NON-NURSING, that gave tips on how to "get what you want". In other words, if someone wants it bad enough, they'll find a way to get it.

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