Drug seeking or real pain? How do you tell?

[JudyPRN]

I'm a new nurse on the list so please pardon my ignorance. I was quite interested in the pain links and explored several and probably will use some for staff training. I did not see any mention of dealing with chemically dependant people who may or may not be having pain. I work in a mental health facility which also serves chemically dependant people. We have a constant struggle with determining who is in pain and who is drug-seeking. We have isolated a few cues, but over-all are probably treating the wrong patients. Does anyone on this list have ideas on this subject, who can steer me to a few resources? I appreciate all the help offered.

[teeituptom, BSN, RN]

To DBMC,

It sounds like you are really fed up and who could blame you. Obviously if you are experiencing pain like this then your pain management is not being controlled very well. This would be enough to drive any one into depression. Here in Nz we have a pain mangement clinic and people are referred to this, do you have one in the states? I am not suprised that you are experiencing pain with what you have described is your condition. Don't lose faith in the medical profession each of those Doctors and nurses are individuals and will all act differently.

As to people wanting pain relief when others who are not the patient think they don't need it. I suggested that they are really maybe in mental pain. A nurse who has many years experience answered my post and said that I was making up excuses for them. Now why would I want to do that. It is not for the nurse to make judgements about who is in pain and who is not. The tolerance of pain varies from one individual to another.[/QUO

Just give them all a menu and let them have what they want

so much easier

[canoehead, BSN, RN]

dbmc- We are talking about people that come to the ER daily or several times a week, and who lie about drug intake; they say they don't take anything, but their drug screen shows 3-4 substances. If someone comes in with pain and I've never seen them before, I believe them until they prove they are lying.

[cmo421]

I forgot that our licence came with ESP. So being the judge and jury makes one feel so powerful and in control. Someday,when we walk in their shoes, we may spend many sleepless nights thinking about those we treated so wrongly.

[teeituptom, BSN, RN]

I forgot that our licence came with ESP. So being the judge and jury makes one feel so powerful and in control. Someday,when we walk in their shoes, we may spend many sleepless nights thinking about those we treated so wrongly.

I do have ESP, I am Extra Specially Psychotic

Were not being judge and jury, we are assessing and evaluating a situation. That is of drug seekers vs real pain. Yes we make these assessments daily.

Actually, it would be easier if the drug seekers just came in and said I need 20 lortabs. More often than not an ER doc would appreciate the honesty and give them a script. All the different dramas we here from drug seekers really is tiring.

Seen a lot of drama lately. Attribute it to the holiday blues. And wanting drugs. "Can you make that the norco's for me. Lortab just doesnt do it"

Had one last week I almost nominated for an Academy Award, for best dramatic performance.

[dbmc]

You're exactly right. It would be much better if a drug addict could tell the truth. However, there's such a stigma towards drug abuse that I don't see that happening anytime in the near future. Obviously, the war on drugs is a complete failure. The U.S. is going to have to come up with a better plan on fighting drug abuse. Most heatbreaking to me is that we live in a world that requires an artificial high in order to cope.

[Kanani_Ikike]

Most heatbreaking to me is that we live in a world that requires an artificial high in order to cope.

If more people trusted in God more than they trust in man, then we wouldn't have so many in that situation. And for those that don't believe in God, they can go with their higher power. People need to start just taking a moment for themselves and meditating. It's always worked for me, even with my migraines. Very seldom do I have to actually pop a pain pill with a migraine. Most of the time a dark room, closed eyes, cool rag, and meditation alleviates it a little. It doesn't completely go away, but I don't strive to be pain-free. I just want the pain to subside somewhat.

[Josh L.Ac.]

If more people trusted in God more than they trust in man, then we wouldn't have so many in that situation. And for those that don't believe in God, they can go with their higher power. People need to start just taking a moment for themselves and meditating. It's always worked for me, even with my migraines. Very seldom do I have to actually pop a pain pill with a migraine. Most of the time a dark room, closed eyes, cool rag, and meditation alleviates it a little. It doesn't completely go away, but I don't strive to be pain-free. I just want the pain to subside somewhat.

Seriously?

Maybe Marx was right, trading one opiate for another.

[Kanani_Ikike]

Seriously?

Maybe Marx was right, trading one opiate for another.

Yes, seriously. I mean, did I make a typo or something?

[Josh L.Ac.]

Yes, seriously. I mean, did I make a typo or something?

I just wanted clarification that you think if more people believed in god, they wouldn't have chronic pain and/or be drug seeking.

Is that really what you are saying?

Or were you saying that calming down and meditating helps with pain, regardless of which deity [or lack thereof] people subscribe to?

[teeituptom, BSN, RN]

Seriously?

Maybe Marx was right, trading one opiate for another.

I think that is a derogatory statement, comparing anything the poster said to Karl Marx. Totally unacceptable

[Josh L.Ac.]

I think that is a derogatory statement, comparing anything the poster said to Karl Marx. Totally unacceptable

Why? Is Karl Marx offensive? I'm not a huge fan of his writings, but I fail to see how he is offensive.

The OP said that belief in god would reduce pain in a thread talking about drug seeking patients. Karl Marx said that "religion is the opiate of the masses", thus my comment about trading one opiate for another.

If anything, I find the idea that if people believed in god then their pain would just go away to be offensive.

[teeituptom, BSN, RN]

Why? Is Karl Marx offensive? I'm not a huge fan of his writings, but I fail to see how he is offensive.

The OP said that belief in god would reduce pain in a thread talking about drug seeking patients. Karl Marx said that "religion is the opiate of the masses", thus my comment about trading one opiate for another.

If anything, I find the idea that if people believed in god then their pain would just go away to be offensive.

I dont find Karl Marx offensive at all. But I know his writing very well.

And when you take someones honest declaration of how to control his pain of a migraine, without taking drugs. Then you compare this with Karl, I find this derogatory.