Patients, Are They really all drug seekers?

Lovely_RN, MSN · Feb 24, 2011

No, all patients are definitely not drug seekers. Also, keep in mind that pain is what the patient says it is. Finally, even if the patient is an addict...depending on where you work...are you their drug counselor or their nurse? Even drug addicts feel pain and sometimes need pain medication for things other than abuse.

I work in an outpatient program and to see how a lot of my patients are treated when they have to be hospitalized is truly shocking. I know some of them can be very disgusting and demanding but they're still human and have the ability to feel pain. I have spoken with MDs who stated point blank that they will cut my patient's dose of methadone or will not administer pain meds because they feel the patient doesn’t need it. Not because as a professional using clinical judgment they feel the patient will be in danger or not benefit from receiving pain meds or a full dose of methadone.

I’ve also worked in LTC and have seen nurses who will do just about everything in their power to avoid administering pain medication. I had to threaten a former colleague because she was withholding Roxanal from a dying cancer patient. It was ridiculous. Was he going to become an addict in the next life? I would never over-medicate a patient or medicate a patient that was obviously under the influence but like it or not if there is an order and the patient says they feel pain then I’ll give it. Who am I to judge anyway?

I'm glad you're asking about this issue and I'm sure that you will never be that kind of a nurse to your patients. My advice to you is to not address the nurses at your clinical site. As a student you don't have the authority or the experience to do so. Just watch what they do and say, quietly, and make a promise to yourself to do better when it's your turn.

ckh23, BSN, RN · Feb 26, 2011

Work in the ER for a few months and see if your perception changes.

Lovely_RN, MSN · Feb 26, 2011

Touché, and with that stated, maybe you go work in anything related to addiction, hospice, or LTC and see if your perception changes.

Work in the ER for a few months and see if your perception changes.

allnurses Guide · Feb 26, 2011

I don't think you should assume that every nurse who says that a patient is a "drug seeker" is not compassionate, is cynical, and/or doesn't treat the patient with dignity.

My dad died of alcoholism, so I can certainly relate to the ravages addiction to drugs or alcohol cause. You will tend to hear that pretty often from Emergency Dept nurses. There are usually a core number of people who come in frequently, ask for specific drugs each time, and often become combative with the staff. Most of them have been referred to detox units, etc many times.

I have compassion for my fellow nurses who manage to treat the patient with dignity every time they interact with that person. But to also ask they not even think "drug seeker" is asking too much. Sharing comments that strike you as cynical might be one way they cope with the stresses of those who do not want to get better, day in and day out, year after year.

If they say that about someone who just wants their prescribed pain meds on time or says that their current med isn't working, that's an entirely different story. I get just as angry as you when they take it upon themselves to curtail pain meds because "they don't look like they're in pain" or "she just had that 2 hours ago". We've had some of our members here with chronic pain describe the nasty way they were treated by overly suspicious nurses, and that is w-r-o-n-g !! Anyway, that's how I see it.

Editorial Team / Moderator · Feb 26, 2011

Drug seekers do exist, but not all patients are drug seekers. Develop your nursing judgment and do the best you can for your patients. That's my advice.

Lovely_RN, MSN · Feb 26, 2011

I don't think you should assume that every nurse who says that a patient is a "drug seeker" is not compassionate, is cynical, and/or doesn't treat the patient with dignity.

I had to re-read what I wrote because I don't see anywhere in my statement where it says: every nurse who says that a patient is a "drug seeker" is not compassionate, is cynical, and/or doesn't treat the patient with dignity.

If that is what you managed to sum up from my comments then maybe I didn't communicate my thoughts as well as I intended too but those are your words not mine.

I didn't write that and I don't believe it.

Yes, there are some drug seeking patients and yes, there are some health care professionals who are cynical and assume that all patients are drug seekers. Finally, just to clarify I was answering the question: Patients, Are they really all drug seekers? With my response being focused on the people who believe that everyone who crosses their path is drug seeking.

ckh23, BSN, RN · Feb 26, 2011

Touché, and with that stated, maybe you go work in anything related to addiction, hospice, or LTC and see if your perception changes.

I don't dispute that there are people with chronic pain that are not drug seekers such as hospice or LTC. However your previous comment "No, all patients are definitely not drug seekers." is flat out wrong. People do get labeled as drug seekers and there is a reason for it. A person who comes through an ED for the 15th time in a month complaining of "chronic" back pain and demanding their Dilaudid 2mg is a drug seeker. I have caught these people in the act because I work at different facilities and have seen the same person within a day of a visit to a previous ED where I know they received a week supply of percocet.

As far a pain being what the patient says it is, let's use common sense. Yes pain is whatever level the patient says it is. However when the person is saying their pain is 10/10 and they can't even stay awake long enough to finish a sentence because they are so high are you really going to give them that morphine/dilaudid/percocet/etc.?

Drug seekers are very real and they are out there. No not every person is a drug seeker, but to believe no exist you are just being naive.

megan_EMT · Feb 26, 2011

I've seen both sides of this issue. I've dealt with lots of drug seekers - we have an ER doc here that works at multiple facilities and has seen the same patient hours apart at different hospitals asking for the same drugs. However, I had a pericarditis & kidney stones at the same time: yeah, that's painful. But the ER decided that I was drug seeking when I was in the ER 3 times in 2 weeks. Finally I convinced cardio to just give me a prescription for pain meds (previously they were giving anti-inflammatory meds and told me to go to the ER if I needed anything stronger). Also, a good friend of mine has a painful and very rare kidney disorder. The ER has completely cut her off from pain meds, and I feel so bad watching her suffer. She probably is addicted to pain meds (she pops percocet like candy), but her pain is real and the condition is terminal - whats the harm in end of life addiction?

Penelope_Pitstop, BSN, RN · Feb 26, 2011

I personally dislike the term "drug seeker."

When I had surgery, the pain afterwards was awful. So was I seeking drugs? Yes, because I required them to relieve my pain.

People with real pain desire relief, and sometimes that involves drugs.

However, the patients I have who ring their bells and ask, "am I due for anything?" (meaning any nausea, pain or anxiety med, or Benadryl) rather than, "I'm having a lot of pain right now. May I have anything for it?" make me wonder if they like the effects of the drug aside from pain relief, i.e. the "high."

Either way, I'll give you meds if they're ordered. But if you're asleep by the time I draw up that Dilaudid...well, you can wait.

allnurses Guide · Feb 27, 2011

Deleted post not intended for the OP of this thread.

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redhead_NURSE98!, ADN, BSN · Feb 28, 2011

I get kind of offended that "Lortab just doesn't work for me" is perceived as "drug seeking behavior." Fact of the matter is that Lortab just doesn't work for me, so if you hand me a prescription for it I'm just going to throw it away.

I am not one to doubt someone's report of pain. If the physician is prescribing it, and the patient isn't sleeping and doesn't have decreased respiration or something, I'll give the med. It is not our job as nurses to decide who's "just an addict" and who's not.