Tips on how NOT to appear like a Drug seeker

[WillowBrook]

Having read through some of the threads regarding Drug seekers in the Emergency Department I must admit I now feel quite nervous of being misperceived in this way. I take medication which causes some urinary retention and increases my risk of Kidney stones. Hopefully this will never happen, but if it does and I need to present to the ED, what advice (on behaviour and what to say for example) can people here give me so I don't get wronly perceived as a Drug seeker. Taking into consideration I am a former Heroin addict, sensitive to NSAIDS and can't take Ibuprofen or Aspirin type medications due to asthma.

[Patma]

I have to admit it but I feel for the people with mental illnesses coming in with pain. They automatically are deemed either neurotic or drug seeking. 10 years ago I was misdiagnosed with a mental illness and put on a whole slew of drugs. I developed severe abdominal pan while at work (I was and still am an RN) The pain was a 50/10 when I moved. As long as I stayed still I was fine with no pain. I had to be picked up from a chair and put on a stretcher taken by ambulance then placed on an ER stretcher. Needless to say I was not handled gently and I screamed in pain. A resident came in told me to stop sreaming then proceeded to ask me what illegal drugs I take and how much alcohol I drink. I told him I work in a jail get random drug tested and I do not drink. He drew blood and refused to give me anything for pain. He then sent me to xray for a sitting and standing KUB. needless to say I could not do it so the Xray tech "helped" and spun me into a dangling position (I was only 85lb) She recieved a reflexive punch in the arm. I was so embarrassed but the tech told me I had nothing to be sorry for it was her fault the resident told her to do it because he thought I was faking. I was diagnosed with pancreatitis with a lipase level off the charts. The resident came into my room and said "now tell the truth how much do you drink" I told him I do not drink he then said well you have severe pancreatitis I said nice how else do you get it he said gallstones. I was admitted to the ICU and almost died. I recovered and had 2 surgeries to remove all the stones (they filled 2 urine cups. When I recuperated I made a date with the medical director and had a meeting with the resident and presented him with the stones. He humbled and said when he saw al the meds I was on he immediately felt I was faking and a drug seeler. Sad to say but I got that whereever I went. Thankful to say I stopped the meds on my own 8 years ago and have had no problem and continue to work as an RN. No one has since ever labled me a drugseeker or neurotic. Go figure

It breaks my heart as I read your story, but it happens all the time. As far as I'm concerned, being "humbled" is not enough for what you went through. He should have been disciplined in some way, so that others will see what happens when you deny a patient relief from pain and for labeling patients as "drug seeking".

Without going into a long story, the same thing happened to me a year ago. I presented with chest pressure/pain and SOB. I'm female, 52 and a smoker. I'm also a patient in a pain management program.

The Nurse in Triage assumed I was a drug seeker and put me on the back burner, so after a few hours, I left and went home. Upon seeing my family doctor a few days later, and after performing an EKG, he immediately sent me back to the ER and they did the same thing again!! I chose not to leave this time because of my Doctor's concern.

My Doctor showed up in the ER several hours later to check on me and found me sitting in the waiting room. He somehow brought me in, ordered an EKG which didn't look so good and then ordered an emergency cath which showed I had an 80% blockage of the left main branch. I needed emergency bypass surgery which was done an hour later. I was told by the surgeon that I could have died at any time if I had not had the bypass.

So, do you think that the Nurse who saw me should get a slap on the wrist?Truth is, I don't care, they all stick together, all I wanted to do was get the hell out of there as soon as I could. As far as they are concerned, anyone who is a chronic pain patient and on narcotics, is lower than s--t, and will be treated as such.

As you can see, I have struggled with this type of discrimination before, and I'm just plain tired and fed up. What can a patient do to protect themselves? Evidently, being in the medical field, and RN for goodness sakes, doesn't stop the discrimination, so what will?

I don't mean to be hard on RN's because the ones that took care of me in CCU were wonderful as was my homecare nurse, but enough is enough. If you were in my shoes, you would be afraid of nurses as I was. I didn't want any nurse near me after what had happened in the ER. I had an angel of a nurse in CCU who set me straight that there are good caring nurses.

[gauge14iv, MSN, APRN, NP]

I want to add - I believe the person - ALWAYS - who presents in pain. They get their pain meds.

The problem arises when they want their refill in 5 days instead of 30, they lose their rx or "leave it on the bus" repeatedly. Even then - they get ONE chance.

THATS where the problems show up - THATS the people who are concerened about it that should be worried about what provider thaty are going to go to next - cuz after they start pulling stunts - it wont be me!

[fsmtg]

I've worked in an ER for several years now and it never ceases to amaze me what lengths these drug seekers will go to. This thread is truer than just about anyone can believe.

[teeituptom, BSN, RN]

Have you noticed how Mediports are now being placed in Drug Abusers, I am seeing more and more of this lately. Amazes me.

[NurseyBaby'05, BSN, RN]

Their veins are probably all blown from years of abuse. All that hard living wears and tears on a body. They probably have real diseases now from all the damage they did over the years. What a mess! It's a shame. By the time I get a lot of these patients, they realize what they have done to themselves and their loved ones, but it's often to late.

[grims_mom]

Someone who wasn't a drug seeker wouldn't even be concerned about this.

I beg to differ. My husband has ulnar neuropathy bilat and also has chronic pain from falling out of a 5-ton army truck with full combat gear (about 60 lbs) on at the time. He has has bilateral tib/fib stress fractures and feet problems from jumping out of planes -all thanks to time in the military. He is in constant pain. He is also a combat medic, paramedic, & law enforcement officer. He will probably have to retire in a couple of years b/c the neuropathic pain and symptoms have become so severe.

Every time he goes to the doctor to discuss pain management he dreads it b/c he worries about telling the doc how much and how often he really hurts. He thinks that it makes him look like a drug seeker when all he really wants is to control the s/s. He is currently on hydrocodone 7.5 & Trazadone (both on his days off), Methacarbamol, Tramadol, 800mg Ibuprofen & Salsalate (when he is working). The Tramadol, Ibuprofen, & Salsalate don't help very much but at least allow him to function at work with only a few people know how miserable he really feels.

Suggestions for him? He does worry about it & is not a drug seeker.

[Cherish]

I just recently got out of the Army. Its a big stigma in the Military to tought it out. Yes it sounds ridiculous but it was hard to tell doctors you were in pain. Most of the time soldiers didn't even go because we were guaranteed Ranger Candy (Motrin 800). They RARELY ever gave you anything stronger when u were definately in pain. I was Airborne and sometimes you land wrong but they rarely gave you anything so most of the times didnt bother. I STILL got huge bottles of 800 and naproxen LOL.

[vamedic4, EMT-P]

I beg to differ. My husband has ulnar neuropathy bilat and also has chronic pain from falling out of a 5-ton army truck with full combat gear (about 60 lbs) on at the time. He has has bilateral tib/fib stress fractures and feet problems from jumping out of planes -all thanks to time in the military. He is in constant pain. He is also a combat medic, paramedic, & law enforcement officer. He will probably have to retire in a couple of years b/c the neuropathic pain and symptoms have become so severe.

Every time he goes to the doctor to discuss pain management he dreads it b/c he worries about telling the doc how much and how often he really hurts. He thinks that it makes him look like a drug seeker when all he really wants is to control the s/s. He is currently on hydrocodone 7.5 & Trazadone (both on his days off), Methacarbamol, Tramadol, 800mg Ibuprofen & Salsalate (when he is working). The Tramadol, Ibuprofen, & Salsalate don't help very much but at least allow him to function at work with only a few people know how miserable he really feels.

Suggestions for him? He does worry about it & is not a drug seeker.

Ouch...I say find a new doctor, preferably one with at least SOME experience in pain management. It bugs the snot out of me that people can't get adequate treatment for their pain. Many doctors are ignorant, scared, or both when it comes to pain management issues.

And thank your husband for his military service, grims_mom;) . I hope he gets to someone who will get him back on the road to wellness again.

vamedic4

[gauge14iv, MSN, APRN, NP]

DEFINATELY needs a pain management specialist.

[grims_mom]

Ouch...I say find a new doctor, preferably one with at least SOME experience in pain management. It bugs the snot out of me that people can't get adequate treatment for their pain. Many doctors are ignorant, scared, or both when it comes to pain management issues.

And thank your husband for his military service, grims_mom;) . I hope he gets to someone who will get him back on the road to wellness again.

vamedic4

Thanks! We are trying to get him a new Dr. but it is through the VA so not likely to happen and he won't refer to a specialist for the neuropathy or the pain.

[LilgirlRN, ADN, RN]

I used to be very judgemental of people who were in "pain" when they came to the ER.

If they didn't appear to be in any pain and rated their pain at 10, I automatically assumed

they wre drug seekers. Now that I have chronic pain myself from RA, I've changed how I think.

However, there are some people who come to the ER wanting more pain medication when they

are falling asleep in the triage office. The amount of pain medication they list as daily med

is completely ridiculous. I've had people 25 years old come in on Fentanyl patches 100 mcg

and Oxycontin 60 q 6 hours for breakthru pain! They'll also be on phenergan, klonipin and soma.

I don't know how these people have any quality of life, I am thinking I would rather have some pain and be lucid than be gorked out of my mind all the time, but then I haven't had to walk a mile

in their shoes either.

[bollweevil]

Thanks! We are trying to get him a new Dr. but it is through the VA so not likely to happen and he won't refer to a specialist for the neuropathy or the pain.

Why no specialist referral? Sounds like you need to start contacting the Patient Care Advocate, Chief of various services (Internal Med, etc.), your senators, even the head of the VA. This is a good time to kick up a fuss if you are not getting adequate help from VA.

One thing I noticed at the VA is that it is staffed almost totally by residents and med students and that attendings, who are paid to be present in the clinics and paid to oversee and actually teach the residents and students, are almost never actually on site or even being consulted by phone. Is that the case where your husband is treated? Is he a guinea pig for learners? Yes, they have to learn but they are supposed to have a teacher present to actually evaluate the patient and do some actual teaching. Does he get a new doctor every time? Not acceptable. Raise H and advocate for your husband until he gets proper care.

Of course, if he has insurance and can see private docs, why not do that?