I agree that we should be aware of the possibility of addiction in patients who constantly ask for pain medication. This has never stopped me from treating all requests for pain meds as legitimate, only allowed me to use my assessment skills in dealing with pain. Pain is one of my priorities and I treat it aggressively. However, I have seen a few cases where I believe they were misrepresenting their symptoms in order to get the meds. I work in an ICU/CCU and only last month we had a patient admitted with chest pain. He watched TV, read, joked with family etc when he didn't think we were looking. As soon as he saw us approaching his room, he turned off the TV, hid the book, stopped talking to family etc and started rubbing his chest and looking distressed. There were no change in his vitals, no ECG or enzyme changes. After treating his pain aggressively for about three days with IV Morphine, Nitro gtt etc.with no change in his complaints, the doctor ordered the IV Morphine changed to Tylenol #3. When I told the patient this, he became very angry, refused the Tylenol #3, stated he had "better stuff than that at home", also said "why didn't you tell me that the doctor was going to D/C the Morphine this afternoon - I've wasted hours here", and signed himself out. I still aggressively treat all complaints of pain but I also use my assessment skills to assess other reasons for frequent requests for narcotics.