Drug Seeker Antics and Dramas

Specialties Emergency

Published

They are an everyday event in almost every ER around the country. What is the drug of choice in your area? I've noticed around here it is Vicodin.

Our latest little treasure was an ex RN who was a daily event in our ER. She would come in complaining of backpaid and demand a shot of demerol and a script for Vicodin. Her MD's (She had many over the years) refused to see her. We kept a lot of documentation on her antics in order to confront her with her possible little problem. Well the big day came, she didn't take it real well. She stormed out of the ER, went around the building, came in thru the main lobby and straight to a pay phone. She called in a bomb threat to the ER. The police tracked her down, they could hear the hospital pages in the background. She is now in a facility.

I believe in adequate pain control. When I send people home with fractures and an appointment to follow up with an orthopedic surgeon (which they will have to drive for a good way to get to), I am not hesitant to write for the Lortab 10. I will light up your world with MS if you come in with ischemic chest pain or fentanyl if you are a major trauma patient.

However, I can't envision a situation in which I would administer dilaudid, morphine, or any other Schedule II narcotic to a patient with a migraine headache. If it ever comes to that, you better believe that I am going to be on the phone with a neurologist asking if he will accept transfer of the patient.

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Specializes in Oncology/Haemetology/HIV.
Steph,

Which Echo Heron book is it in? I do remember one of the books when a pt pronounced morphine, "Mopheen" (or something like that), but it didn't say it was a "pound of mopheen." Just curious, am I missing an Echo Heron book somewhere?? I tell ya, in my summer read mode, a new Echo Heron book would really hit the spot. :)

Ditto, the patient wanted Mofeen(?) for chest pain....to my knowledge there was never an attempt to get a pound of it, though. I think that the poster may be mistaken regarding their source.

I have had numerous patients pronounce it like that, though.

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If you go to the ER can you request a CT. Is that something the can do that day or will they refer you elsewhere. I have had chronic headaches all of my life. I don't know If they are migraines because sometimes I have the pain on both sides of my head, though rarely. I don't believe my DR is doing enough. I was prescribed Hydrocodone 10 and Naproxsen. The Hydrocodone makes me vomit. I've tried it with and without food. When I cut it in half I didn't vomit but it did not get rid of the pain. I am afraid of going to the ER because I don't want to be treated as a drug seeker. In fact, I don't want drugs I want a CT. Something has to be going on in my head to make me feel this way. I'm scared I'm going to have a stroke. Lately I can even hear the blood rushing in my head. I don't believe that is normal but I don't know. I was told to take one Naproxsen, can I take two and not OD?

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SLOW DOWN! No one was trying to offend you here. I am perfectly aware that there are pts with little to no relief for what ails them. I wasn't pointing fingers at you or anyone else. If you will recall, the title to this thread was drug seekers and their antics. That's exactly what I was talking about...seeking. Sorry to have struck a nerve with you. Never intended it that way.

:chuckle :chuckle Here we go. I get migraines and Imitrex and Maxeran do wonders....however not all the time. Every 4 months or so I get one that won't go away. After 72 hours, status migrainous, and after about 6 Naprosyn, Tylenols, 2 Imitrex and the dark room full of ice....I haul a*** to the ER. Here I feel like I'm getting the "looks". Even armed with my letter from my PCP that states narcotics are sometimes needed, I follow up every 3 months and I'm on Propranolol daily. I'm very happy that you get relief every time you take your rescue meds, but not everyone does. Always. :crying2:

And believe me it is HELL going to the ER for that complaint. And I do dry heave as well since I'm always dry as a bone by the time I get there. 180/90, 37.3 Total pain

I get the dark room upon arrival, a bolus of saline, 30 Torodol, 10 Maxeran, 50 x 3 Demerol. (over a period of 6 hours mind you.)

Severe adverse reactions with Stemetil, DHE and Decadron.

Sucks.

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If you go to the ER can you request a CT. Is that something the can do that day or will they refer you elsewhere. I have had chronic headaches all of my life. I don't know If they are migraines because sometimes I have the pain on both sides of my head, though rarely. I don't believe my DR is doing enough. I was prescribed Hydrocodone 10 and Naproxsen. The Hydrocodone makes me vomit. I've tried it with and without food. When I cut it in half I didn't vomit but it did not get rid of the pain. I am afraid of going to the ER because I don't want to be treated as a drug seeker. In fact, I don't want drugs I want a CT. Something has to be going on in my head to make me feel this way. I'm scared I'm going to have a stroke. Lately I can even hear the blood rushing in my head. I don't believe that is normal but I don't know. I was told to take one Naproxsen, can I take two and not OD?

I take 6 over a period of 2 days. I take 2 at onset as prescribed by my doctor. I think it works great BUT.....not always. Why is it so hard for people to understand that I wonder? Even birth control doesn't always work. :confused:

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SLOW DOWN! No one was trying to offend you here. I am perfectly aware that there are pts with little to no relief for what ails them. I wasn't pointing fingers at you or anyone else. If you will recall, the title to this thread was drug seekers and their antics. That's exactly what I was talking about...seeking. Sorry to have struck a nerve with you. Never intended it that way.

No nerves struck :D None by you folks here anyways. I just find the whole issue maddening. I believe if there ever was such a thing as a picture perfect migraineur, it would be moi, and I get hurt when I get treated otherwise upon arrival at my hospital. It is so hard to figure out who's seeking for the right reasons, and who isn't.

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Specializes in ICU/CCU, Rehab, insurance, case manager.
This same story about "mofine, 1 pound" has been going around for years. It is in an Echo Heron book. My ER doc told me it happened in med school. I've heard this story from numerous nurses through the years.

Urban myth? Old-wives-tale?

steph :)

off note-Echo Heron -excellent author, very enjoyable reading!

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"If you go to the ER can you request a CT. Is that something the can do that day or will they refer you elsewhere. I have had chronic headaches all of my life. I don't know If they are migraines because sometimes I have the pain on both sides of my head, though rarely. I don't believe my DR is doing enough."

Sounds like you need to see a new doctor, MyReign1.

(couldn't find the quote thingy)

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I have had a couple that nothing short of barfing and Kevorkian? would make me feel better. It hurts just to take a deep breath. So I know what you mean. I worked with a ER doc once that believed in 5omg Benadryl and 1 liter of NS for migraines. Amazingly, he had quite a bit of success. I hope you find some relief for yours. Good luck.

No nerves struck :D None by you folks here anyways. I just find the whole issue maddening. I believe if there ever was such a thing as a picture perfect migraineur it would be moi, and I get hurt when I get treated otherwise upon arrival at my hospital. It is so hard to figure out who's seeking for the right reasons, and who isn't.[/quote']
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It just annoys me that a few rotten apples has messed things up so that E.R. staff casts a jaundiced eye on EVERYBODY. Not that I blame them for it, they have to be skeptical to make sure the complaint is legit and not just a Dr. Feelgood run. It really ends up hurting the people who are in pain the most and that just sucks.

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I have had a couple that nothing short of barfing and Kevorkian? would make me feel better. It hurts just to take a deep breath. So I know what you mean. I worked with a ER doc once that believed in 5omg Benadryl and 1 liter of NS for migraines. Amazingly, he had quite a bit of success. I hope you find some relief for yours. Good luck.

{{{{{ang75}}}}

Yes I totally understand. Many times I wished for Dr Kovorkian to be on duty but alas....it was not meant to be :chuckle

NS and Benadryl? Whatever. It never worked for me. If it worked for others, hats off to them. Like I said before, by the time I get my butt into the ER, I'm dehydrated, heaving, pissed off, depressed and in so much pain (after 72 hours) I want to be euthanized. I just pray that there's a doctor and nurse that understands me on shift that night. Like I said before...I even have a letter from my PCP that states I sometimes need to come into ER for pain control...but....they probably don't beleive me. WHY????? :stone

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"It just annoys me that a few rotten apples has messed things up so that E.R. staff casts a jaundiced eye on EVERYBODY. Not that I blame them for it, they have to be skeptical to make sure the complaint is legit and not just a Dr. Feelgood run."

In general a person who presents in a lot of pain will also display other signs to back up their claim, Vital signs, palor, dry mucus membranes etc. Most of the frequent flyers have found it so easy to come in and get their supply they barely try to perform for us anymore. You'll see them drive up and pop out of the car and come striding up to the door. They may even stop and have a quick smoke. A lot of times they will smell of ETOH.

The ones who are truely in pain are wonderful to work with, you can help alleviate their pain. That makes the nurse feel good.

When you have to take time away from legitimately ill pts to take care of someone who is there like clockwork it drives you a bit nuts.

One tip: If you have a private Dr for your migraines and chronic pains have him or her write out an emergency pain plan for you. Have him/her also have their phone number for the ER doc to call if needed. It keeps care consistant and hopefully speed the process up for everyone involved. Most pain management Dr s want to be informed if their client has to utilize emergency facilities often. It may mean that their pain management care needs to be re-evaluated.

True pain is always an emergency!

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