Doctors on Alert for ‘Drug Seekers’

What’s the quickest way for a pain patient to be labeled a drug seeker?

Ask for a drug!

That’s no joke. Drug diversion experts say red flags go up when a new patient walks into a doctor’s office and asks for a particular type of painkiller.

bigstock-medical-exam-7540763“It may be that the medication prescribed by another physician was very helpful to them. but walking in that door asking for a specific drug, my radar would be up,” says Charlie Cichon, executive director of the  National Association of Drug Diversion Investigators, a non-profit that educates health care providers about drug abuse and diversion.

“Some physicians like to prescribe a certain oxycodone or hydrocodone pill. That’s what they’ve seen that helps most of their patients.”

So when a new patient asks for something else, Cichon says a doctor may quickly grow suspicious that a patient is a potential drug abuser or dealer.

“A patient who comes in saying, ‘You know maybe I shouldn’t have done this, but I tried this pill that my cousin had and it really did help me. I was able to drive my car, I was able to pickup my kid, or I was able to go to work.’ That would really, I think, set off some kind of alarm.”

Cichon and his colleague John Burke recently completed a series of seminars at  PAINWeek, a national health conference in Las Vegas for practitioners in pain management. Their lectures on topics like “Protecting Your Medical Practice” and “Drug Diversion and Pain Management” were standing room only —  the room filled with hundreds of doctors worried about becoming unwitting casualties in the War on Drugs.

“The physicians really don’t want a visit from law enforcement or the regulatory board. Everybody’s looking at different monitoring systems and counting pills. How many is the doctor prescribing? How many is the pharmacist filling?” Cichon told National Pain Report.

“Unfortunately, its possibly harming the legitimate patient that’s out there, who is trying to get legitimate pain medication and trying to fill it too.”

Cichon and Burke say actual drug seekers use a whole range of techniques to woo or scam physicians into prescribing pain medicine; such as complimenting the doctor, deliberately mispronouncing a drug’s name, threatening to sue, or becoming agitated when a doctor prescribes something besides their drug of choice.

“If you’re in a pain management practice, and even if you’re not, you’re going to get duped from time to time,” said Burke, who is President of the National Association of Drug Diversion Investigators.

Burke advises doctors to get new patients to fill out detailed history forms listing the drugs they’ve taken and the practitioners they’ve seen. Patient names should also be run through prescription drug monitoring systems. If one isn’t available, he suggests calling the patient’s old doctors or even local emergency room physicians to verify the information they’re given.

“You might learn a lot about your patient that you didn’t know. What goes on at 3 o’clock in the morning in the emergency room may be a lot different in your office at 3 o’clock in the afternoon.,” Burke said.

Even the patient’s behavior in the waiting room can be a telling sign. Burke says doctors should listen to their office staff, because they are often the first to recognize a drug seeker — who may act nervous or impatient while waiting to see the doctor.

“You really have to know your patient, especially if you believe that patient is going to be coming on a regular basis and you’re going to be prescribing these drugs that are abused,” says Cichon.

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6 Responses

  1. k johnson says:

    I have Lupus and many complications including neruopathy that is all very painful I have been with my same doctors for many years now so they know my history and what I take and need. I don’t feel like doctors should be punished for giving their patients pain medications if they know or feel they need them. That is why they are made is for people in pain, so why should we be punished for a few drug seekers. The doctors if they take their time and talk to the patient new or not can usually tell if they are seeking pain meds or if they are truly in pain and need to be on pain medication. I think the government is taking this way to far and it is getting out of control and it is only hurting the people that truly need the nedication and the good doctors, that prescribe them. If your going to punish the patients that have chronic pain and the doctors for giving them pain medications why in the hell make them. I am pissed tested and watched for what I take, but if they are taken away from me or my doctor is not allowed to give them then we have to suffer in pain when there is medication being made for that purpose.

  2. Rainey says:

    It’s impossible to tell if a patient is a drug seeker. It cannot be done. Anybody who otherwise is a total liar. Even if they believe their own B.S. The truth is that addicts are everywhere. They can look well turned out, functional, working adults. It could happen to anyone. They could even be doctors themselves. It’s unnecessarily harsh and fruitless for doctors to “predict” who will be and addict. They seem all too willing to use this excuse to deny beneficial medication to chronic pain patients.

  3. In the current legal climate of pain medicine, the fallacy is that every pain patient is expected to be treated as if they were a NEW patient at each and every visit. Those are the models imposed when the DEA and many state medical boards begin dictating specifics of care.

    The first three elements of the medical history are 1. Chief Complaint 2. History of the present illness and 3. Past medical history.

    For the chronic pain patients the 3rd element is now de facto modified to become “Past medical history of all issues EXCEPT what has happened with regard to pain issues. If the patient presents any history of what works and what doesn’t work with regards to pain treatment, they are automatically considered to be a drug seeker.

    On the other hand the doctor is encouraged to prescribe, not what works for the chronic patient, but what is in the doctor’s comfort zone. Keep in mind that for most chronic pain patients (as opposed to addicts) the ineffective medication will end up sitting on the medicine cabinet shelf where it is much more likely to be diverted by the non-pain (?teenagers) who might have access to these medications….that were doomed to end up in the wrong place simply because the patients past medical pain history was ignored. Or worse, the patients past medical pain history was SUPPRESSED by misguided regulations.

    The CHRONIC pain patient deserves better treatment than to have the inclusion of their past medical pain history suppressed by fears.

  4. Kay Redmon says:

    I have suffered from RA, FM & CFS, for the past 35 years & it’s only been the past 12 years that I have been given Oxycodone & Panadeine Forte for relief of the excruciating pain which has confined me to a wheel chair. Maybe with better treatment this could have been avoided. As Jackie T commented, we do not need these drugs to get “high” just for some relief from the never ending pain. I would like to see some of these Dr’s & do gooders to have to endure this for some time, maybe their outlook would change very quickly..There is a big difference between sufferer’s & druggies…

  5. Jackie T. says:

    What irks me is, there’s people that are in pain. We try and get pain meds and we’re told to go take aspirin or Tylenol. I have RA and Fibromyalgia. The most my doctor will give me is Tramadol and that’s only at night. I’m not a druggie. I don’t want pain meds to get “high”. I want some relief from my chronic pain. It takes a few druggies to ruin it for us that are in pain and need these meds!

  6. LKnight says:

    Maybe I’m mistaken but, wasn’t there just a national report done on this very subject? I’m pretty sure I remember it saying that drug seekers are the minority.

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