Drug seeking patients?

[butter]

What do people think about the term drug-seeking patients? I guess I have a hard time with it because usually these people are complaining of pain and who are we to judge whether they are or are not in pain. On the other hand, though, they are usually patients who are hospitalized frequently but may not have any medical reason to be there besides pain. What are your thoughts?

[Crumbwannabe]

Isn't immediate treatment for hyperglycemia or hypertension; or buying laxatives or decongestants "drug seeking"? Of course it is. If I go to my M.D. because I have an abcess and need antibiotics, I am seeking a drug, otherwise, I wouldn't be sitting in an office and shelling out money. I can see no moral import to the term "drug seeking", and plenty of shock value and abandonment of responsibility.

Of course in a time when our country is "addicted to oil", has "Drug Czars" (Czar may be translated as despot), and an endless string of nonsensical terms used for mere semantic value, some tend to be careless with words. But it is generally at the very time that words must be the most precise. Else If I am addicted to oil, I should certainly be in treatment in hopes of becoming 'oil-free'.

If it is your judgement that someone is faking it to get a fix, (must be nice to be able to do such in-depth diagnosis in such a short period), then by all means, say it, and make arrangements to get them some detox assistance immediately. I mean, as a DSM diagnosis, addictive behavior must be addressed as a medical problem just as sure as a hot appendix.

If someone hurts, they hurt. Take it to the lowest common demominator. I have seen more instances of 'good people' who we all need to be protected from than people of good will. Usually what Peter says about Paul tells me more about Peter than it does Paul. Don't let people hurt because it makes you a hero in the "Drug War", or because of your own predjudices about a drug, or a person who is perhaps in need of hygene, or fill in the blanks, lest I be branded as one who stereotypes. I expect a professional to be critical enough to avoid being influenced by overblown media and self-perpetuating politicians, and especially to have enough respect for their own autonomy / ethics to seperate out the nonsense, and act like a professional faced with a unique problem in a unique patient.

This nonsense rubs off on families who take care of elderly family members and then dismiss expressions of pain as "attention seeking", or some other excuse to offer them relief or consult a practitioner. I have seen it before, and I am seeing it happen now, though without power of atty, I can do little.

I have seen 'professionals' put a patient on a cold table in a cold room, and refuse him a blanket saying "F!@# him, he's just an alky".(Yes, I got the warm blanket). But then, these are the kind of people in the profession who perform according to their predjudices and gut feelings. And if a few 'bad eggs' continue to practice, we can certainly allow for a few as patients without getting too self-righteous.

[krisssy]

Isn't immediate treatment for hyperglycemia or hypertension; or buying laxatives or decongestants "drug seeking"? Of course it is. If I go to my M.D. because I have an abcess and need antibiotics, I am seeking a drug, otherwise, I wouldn't be sitting in an office and shelling out money. I can see no moral import to the term "drug seeking", and plenty of shock value and abandonment of responsibility.

Of course in a time when our country is "addicted to oil", has "Drug Czars" (Czar may be translated as despot), and an endless string of nonsensical terms used for mere semantic value, some tend to be careless with words. But it is generally at the very time that words must be the most precise. Else If I am addicted to oil, I should certainly be in treatment in hopes of becoming 'oil-free'.

If it is your judgement that someone is faking it to get a fix, (must be nice to be able to do such in-depth diagnosis in such a short period), then by all means, say it, and make arrangements to get them some detox assistance immediately. I mean, as a DSM diagnosis, addictive behavior must be addressed as a medical problem just as sure as a hot appendix.

If someone hurts, they hurt. Take it to the lowest common demominator. I have seen more instances of 'good people' who we all need to be protected from than people of good will. Usually what Peter says about Paul tells me more about Peter than it does Paul. Don't let people hurt because it makes you a hero in the "Drug War", or because of your own predjudices about a drug, or a person who is perhaps in need of hygene, or fill in the blanks, lest I be branded as one who stereotypes. I expect a professional to be critical enough to avoid being influenced by overblown media and self-perpetuating politicians, and especially to have enough respect for their own autonomy / ethics to seperate out the nonsense, and act like a professional faced with a unique problem in a unique patient.

This nonsense rubs off on families who take care of elderly family members and then dismiss expressions of pain as "attention seeking", or some other excuse to offer them relief or consult a practitioner. I have seen it before, and I am seeing it happen now, though without power of atty, I can do little.

I have seen 'professionals' put a patient on a cold table in a cold room, and refuse him a blanket saying "F!@# him, he's just an alky".(Yes, I got the warm blanket). But then, these are the kind of people in the profession who perform according to their predjudices and gut feelings. And if a few 'bad eggs' continue to practice, we can certainly allow for a few as patients without getting too self-righteous.

WOW great post! Thank you .

[clee1]

Isn't immediate treatment for hyperglycemia or hypertension; or buying laxatives or decongestants "drug seeking"? Of course it is. If I go to my M.D. because I have an abcess and need antibiotics, I am seeking a drug, otherwise, I wouldn't be sitting in an office and shelling out money. I can see no moral import to the term "drug seeking", and plenty of shock value and abandonment of responsibility.

Of course in a time when our country is "addicted to oil", has "Drug Czars" (Czar may be translated as despot), and an endless string of nonsensical terms used for mere semantic value, some tend to be careless with words. But it is generally at the very time that words must be the most precise. Else If I am addicted to oil, I should certainly be in treatment in hopes of becoming 'oil-free'.

If it is your judgement that someone is faking it to get a fix, (must be nice to be able to do such in-depth diagnosis in such a short period), then by all means, say it, and make arrangements to get them some detox assistance immediately. I mean, as a DSM diagnosis, addictive behavior must be addressed as a medical problem just as sure as a hot appendix.

If someone hurts, they hurt. Take it to the lowest common demominator. I have seen more instances of 'good people' who we all need to be protected from than people of good will. Usually what Peter says about Paul tells me more about Peter than it does Paul. Don't let people hurt because it makes you a hero in the "Drug War", or because of your own predjudices about a drug, or a person who is perhaps in need of hygene, or fill in the blanks, lest I be branded as one who stereotypes. I expect a professional to be critical enough to avoid being influenced by overblown media and self-perpetuating politicians, and especially to have enough respect for their own autonomy / ethics to seperate out the nonsense, and act like a professional faced with a unique problem in a unique patient.

This nonsense rubs off on families who take care of elderly family members and then dismiss expressions of pain as "attention seeking", or some other excuse to offer them relief or consult a practitioner. I have seen it before, and I am seeing it happen now, though without power of atty, I can do little.

I have seen 'professionals' put a patient on a cold table in a cold room, and refuse him a blanket saying "F!@# him, he's just an alky".(Yes, I got the warm blanket). But then, these are the kind of people in the profession who perform according to their predjudices and gut feelings. And if a few 'bad eggs' continue to practice, we can certainly allow for a few as patients without getting too self-righteous.

VERY well said! Bravo!

[PrettyPillz]

I feel it is fairly easy to recognize a "drug-seeker". We as nurses are taught to notice signs of possible addiction or abuse of medication. We are to assess patients first of all...such as vital signs, orientaion, alertness. If a patient is wide awake, laughing and chatting on the phone, going to smoke a cigarette and such...heck I've even seen patient set alarm clocks in their rooms to wake them when the next dose of pain meds can be administered!...I have also witnessed patients looking into the MAR to "see what they can have". No facial grimaces. No nothing. But they claim a pain scale of 10/10! You have to use your good judment. HOWEVER, I'm not Dr. Phil.After I have made my assessment and deemed the request for the pain med unfounded,I use other tecniques with the patient to relieve pain such as repositoning, relaxation and other ways. Also patient teaching about what the over use of these meds can do their body. And document well. Drug-seekers will report you and if you don't document well on them, it will come back to bite you later. They are very manipulative. Very good at staff-splitting also. You can only give them the meds as scheduled though and notifiy the physician of your concerns for the patient. Recommend a pain-management doc to come in to the primary doc. But unfortunatley, unless it is physcially contraindicated, such as pt's blood pressure too low or other clinical issues, we have to medicate them for pain. We can teach 'em and medicate 'em....That's all!

[Gr8Dane]

I know we are not supposed to judge someones pain, as pain is unique to everyone. But, these individuals take away precious time that could be spent on patients that actual require nursing care.

Their also incredibly mean, rude, and disrespectful. They believe my job is to give them their pain meds 10-30 minutes before their even due! Their on the call bell and once their buzz wears off they demand the Doctor to be called for stronger meds. They know just when their meds are due and their on the call bell promptly 15-30 minutes prior to the earliest time they can be given "reminding" me they want their pain meds ontime. (lol)

My hospital even lists these people as "Seekers" by putting a "S" on their charts/medical records. They always come in with Migraines. So CT's, MRI's, etc get done every time they come in, which is generally every 1-2 months. Nothing is ever found, they bother us for a few days, cost the tax payers a fortune, then get sent home only to repeat this same process for more drugs.

The biggest problem I have is there are certain doctors that KNOW they are seekers. The patients will demand we contact their doctor for stronger pain meds. When we call the Doctor he just says "Ask them what they want". How the hell does this help anything?

I know this is a wide-spread problem but is it this bad everywhere? Does any place have actual laws/rules against this?

[NurseCherlove]

I feel the same way you do. It is so irritating when you think about it: the costs to taxpayers and the added stress to a nurse's daily routine, not to mention stealing valuable time away from "true" patients.

What I love is to see is when a Pain Management service fires them!

Does make you wonder though, if those kind of docs have ever broached the "possibility" of addiction with them. Likely not.

I think that some of these docs are a little unscrupulous. I've had this conversation with my fiance a few times (GI doc). He used to work with another doc whose regulars just loved him, as he would always give them just what they wanted - ya know, those mysterious abdominal pain of unknown origin patients.

[leslie :-D]

this is an age-old and ongoing problem.

you will hear from those with genuine, chronic pain- citing their reasons for undesirable behaviors.

and it's too bad.

because it really does negate the agonies of those who DO suffer.

that said, doctors MUST start asserting their expertise in differentiating the seekers from those w/actual pain.

and, for those w/chronic pain, manage them better at home, so they don't have to go to the er.

start implementing more pain specialists.

for those who abuse their meds, give them a one-time, long-acting dose and refer them to rehab, as well as pain mgmt.

there has got to be more limit-setting.

do not let these addicts abuse you!

if they do, get help- get security.

but do not let them bully you.

their instability can make them ruthless.

and most of them, need a dopeslap on the upside.

they need to know that we know they have addiction problems , and they need help.

at the risk of sounding like the mean witch, i've never had any problems with telling the addicts, that they will have to wait- period.

and no one seems to like my angry face...

so it works.

just make sure they're not in pain!

that's all i ask.

leslie

[Noryn]

You should do a search, it has been discussed here many many times. There really isnt a whole lot that can be done. Many nurses feel that it is not their concern as they would rather take a chance on giving a seeker their fix as opposed to not treating someone who is really in pain especially if it is IV medication that they have control over.

It really is tough especially today with hospitals stressing customer service and organizations stressing pt rights. For now I think ultimately the answer is to treat their pain as that seems to be the standard now.

I do think that the public is going to start holding healthcare professionals much more accountable in the future over medication especially in the wake of prescription drug overdoses and abuse. I think that is an outcome some do not realize. There is a large number of pills being sold on the street which are killing teens and young adults.

I do think we need to use more common sense.

[Tweety, BSN, RN]

Hi! This is a hot topic, worthy to be discussed, but we have many pages already in ongoing discussion, some several years old. I will be merging your's with one of these, because we really don't need another dozen pages saying the same thing.

I hope you can learn from these threads and encourage you to ask questions.

https://allnurses.com/forums/f186/drug-seeking-real-pain-how-do-you-tell-53486-11.html

https://allnurses.com/forums/f18/tips-how-not-appear-like-drug-seeker-176116.html

https://allnurses.com/forums/f86/drug-seeking-patients-7225-12.html#post2652539

[Gr8Dane]

My biggest concern tho is, that in the past before I was a Nurse and just a PCT, some of these seekers were VERY ruthless, they even went as far as to CALL our CEO saying we are neglecting them. They will curse, scream, wither in agony to the point where you do believe it. And I did actual believe they were in pain, perhaps they brought it on by believing it so much it became true?

I hear other states have strict rules on narcotics prescriptions, but does this include hospitals?

[Gr8Dane]

Ahh search option should have done that first. You can close this thread and I'll move onto those, sorry about that.

[Tweety, BSN, RN]

Ahh search option should have done that first. You can close this thread and I'll move onto those, sorry about that.

No problem at all. You're new here and don't know our history. It can be a hot topic with judgments, defenses thrown all around, but we shouldn't shy away from the topic, I just feel best to keep yours with an existing one.

Enjoy the thread.