#20: Recognizing Drug Seeking Behavior
I have stated it before, however it is worth repeating; “Dependency on prescription drugs can occur at any age, within any cultural group and across any educational class.” Drugs do not recognize color, social status, economic standing or educational prowess. They do not discriminate. No one is immune to the potential risk associated when taking a mood/mind altering drug. Are you able to recognize drug seeking behavior in your patients? What about your neighbors? How about the person that babysits your child for hours at a time? Okay, now I have your attention. In today’s society, it is almost guaranteed all of us run into someone taking some type of mood altering drug, either legally or illegally on a daily basis.
The first step in learning how to recognize drug seeking behavior is to realize, and accept the fact, it exists. Individuals who express anger when questioned closely about pain symptoms they are complaining about. Patients asking for specific drugs by name, while claiming no others work. Perhaps you have patients asking for an increase in the dosage of their meds on every visit, claiming the prescribed meds are, “Just not strong enough.” Then there are those who make excuses why they can’t take alternative drugs, such as claiming multiple allergies. Do you know anyone who uses a controlled substance for something other than for what it was prescribed, such as enhancing one’s mood or using an opioid to help one sleep? What about the individual who takes extra, because one “just isn’t strong enough” or someone you know asking you about your prescribed medication and might they be able to have what you no longer take? Anyone involved in pain treatment has seen the patient who is focused more on getting drugs, than on the problem the drugs were prescribed for.
None of these behaviors alone would stand up as the definition of drug seeking behavior, however when you begin to see two or three of them exhibited by a patient or someone you know, it should raise suspicion. I once had a patient, actually the woman who sold me my house, come in for pain treatment and request Percocet because “Hydro” just wasn’t strong enough. She went on to say, before we even offered, that epidural steroid injections, facet blocks, physical and chiropractic therapy, and any other physical treatment wouldn’t work on her. Percocet 10, three times a day were the only thing that worked for her. Yes, she was that specific. Needless to say her urine drug screen and confirmation came back a bit “dirty”. I was so disappointed. As we could not offer her any pain or anxiety medication she refused any of the many other treatments we had available. Sadly she passed away about a year later from an overdose of opioids.
Not everyone’s drug seeking behavior is so obvious and it takes experience to recognize it. Everyone gets fooled so do not beat yourself up if it has happened to you. Don’t judge, be attentive, and learn from every encounter.
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President/CEO Industry Lab Diagnostic Partners