I give in to drug seeking patients

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I have to admit it. I am a sucker for a drug seeking patient. It's not that I actually feel sorry for them, or that I am too stupid to see right through their ploys. It's just that I don't feel like it's my place to judge them. I also don't think that I am willing to take the risk that they may NOT merely be drug seeking, that maybe they are really having actual pain. Drug seekers often DO have pain. And just because they are annoying does not give me the right to deny them the medication their pain warrents.

Any other thoughts?

If you prescribe it, they will come. And come. And come. And come. Perpetuating their abuse/addiction is not helping them!

On my floor, nurses do not prescribe meds. Doctors do. Preaching to the choir here.

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Specializes in Med-Surg, Cardiac.
you don't work in an ER. It bogs down the system. They need to follow up in a pain clinic.

Bogs down the system on the floors too, dropping everything to give frequent pain meds, especially if you have multiple pts with frequent pain med orders. I like PCAs so the patient can administer his own meds, but MDs seem reluctant to order them for some reason.

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Specializes in neuro/ortho med surge 4.

If there is an order for pain medications I will administer and watch the patient so they do not ge too much. I do not know if some of them are drug seeking or truly in pain. I have my suspicions when some one says they are a 10/10 but are eating a hamburger with one hand and are chatting up a storm on their cell phone with the other. I still medicate regardless. As long as they are tolerating the narcotics. I am not an addiction counselor or a psychiatrist and neither do I have time to go round for round with these people. Drug seekers take enough of our time as it is.

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Specializes in Med-Surg, Cardiac.

I have one friend who has serious back pain from well documented vertebral and disc problems. I've often noticed that she seems like a "seeker" and I guess she is because she knows how bad her pain will be without the meds. Her pain varies from day to day. Most days she keeps it under control but there are days when all her meds can't control it. She was recently hospitalized and I'm sure he nurses thought she was a seeker because she got so upset because it took the admitting MDs and pharmacy a while to get her pain med orders straight and she needed her meds.

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Specializes in Hospice.
I have one friend who has serious back pain from well documented vertebral and disc problems. I've often noticed that she seems like a "seeker" and I guess she is because she knows how bad her pain will be without the meds. Her pain varies from day to day. Most days she keeps it under control but there are days when all her meds can't control it. She was recently hospitalized and I'm sure he nurses thought she was a seeker because she got so upset because it took the admitting MDs and pharmacy a while to get her pain med orders straight and she needed her meds.

This is pseudo-addiction ... something that is well-known to pain specialists. Certain personality types tend to develop such behavior in response to inadequate treatment.

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i don't get too wrapped up in the morality of it. our system is biased towards giving the meds. you are just a cog in that wheel. it is annoying, especially in the flagrant cases, but i try not to fret about it. we are not the bad guy here, whether you believe them or not, we still have to chart what they say, and give the meds as ordered. i'm not saying we are devoid of responsibility in informing the md what we think, but they have the accountability which favors giving the drugs. true reform exists at the institutional level, should you want to get involved. i read recently about some ers that no longer prescribe narcs to patients being released. they are treated, then discharged with no rx :)

that's just ridiculous. seriously.

i drove myself to the er once with a fever of 104, the worst sore throat of my entire life, and absolutely excruciating body aches. i had a terrible case of the flu. i have never been in so much pain in my life. i was sent home with a prescription for lortab elixir. once i got it onboard, i finally realized there is a god. i needed that medication, it was prescribed at an appropriate dose, with no refills.

i feel angry that patients who have completely legitimate need of narcotic pain killers are being denied their pain relief because of a blanket policy aimed at drug seekers.

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Specializes in ER, Trauma.
On my floor, nurses do not prescribe meds. Doctors do. Preaching to the choir here.

Alright, alright. I just wanted a little artistic license.

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Specializes in LPN.

I am finding that "drug seekers" not only ask for narcotics, but for other meds that increase the effect on the narcotic. I am not always sure if the combinations they seek are harmful. Many of them ask for phenergan,or things. I have seen groups of them talk, and then the same thing is requested from each one of them. I know what they are doing, and it falls within the range and times of PRNs written. But, I feel like I am being taken on a trederous path. I understand what they want, but I want to keep my liscene. Any ideas?

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Specializes in Hospice.
I am finding that "drug seekers" not only ask for narcotics, but for other meds that increase the effect on the narcotic. I am not always sure if the combinations they seek are harmful. Many of them ask for phenergan,or things. I have seen groups of them talk, and then the same thing is requested from each one of them. I know what they are doing, and it falls within the range and times of PRNs written. But, I feel like I am being taken on a trederous path. I understand what they want, but I want to keep my liscene. Any ideas?

If the meds are legally ordered and you observe no allergies, adverse reactions or other contraindications, in what way is your license threatened?

Trust me, if you invest your energy into controlling or preventing someone from getting high, you will lose.

If you feel that the med orders are enabling addictive behavior, it needs to be dealt with by the team ... md, nursing, social services, and admin.

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Specializes in Hospice.

I work in hospice and currently care for a patient who is an addict and in terrible pain. We are not going to cure either, but by getting her proper pain meds and limiting her access to them, she is doing better than she has in years. There is a middle ground, but I can not imagine that most types of medicine have the time or the patience to carefully build the relationship that allows that middle ground to be reached. In the hospital though, I treated reported pain as ordered by the MD. I do not have the ability to know if someone is in pain, so I generally take their word for it.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

If the doctor orders it and the patient asks for it, I wouldn't be inclined to step in and add my opinion as to what is truly motivating the request, unless that patient appears to be intoxicated.

I've always wondered though, when I read about how common it is for addicts to come in with false or misleading complaints, deal with the wait time, the delays etc all for a dose of narcotics that will wear off pretty quickly or a small number of Vicodin and more lectures and referrals to detox centers they will never go to.

Seems like a low return on investment if the goal is to get high. Maybe there is something to it I am missing.

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you don't work in an ER. It bogs down the system. They need to follow up in a pain clinic.

I totally agree with this. At the same time, it's not like I can tell them they can't have their pain meds if the doc orders it and vitals are stable. So for me, it just quicker and easier if I give them their meds so I can move on to someone else who really needs me, at least for the next hour or so... :)

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