One common objection to physician dispensing is the challenge of managing drug seekers. Though drug seekers can be a problem for any prescriber, dispensing physicians have the additional challenge of dealing with a patient who knows they have products at the clinic.
The first part of this post series will focus on identifying drug seekers. The DEA says some common signs of seekers include the following:
- Assertive personality, demanding immediate treatment
- Unusual appearance – either too sloppy or too well-dressed
- May exaggerate medical problems or simulate symptoms
- Will often request a specific controlled substance and be hesitate to try another drug
- May show unusual knowledge of controlled substances or give textbook answers for symptoms
Pharmaceutical dispensing may attract seekers and the physician should be looking for some of these “tricks”:
- Must be seen right away
- Wants to be seen near the end of office hours or after regular hours
- Feigns physical or psychological problems
- Contends that his/her regular practitioner is not available
- Non-resident – passing through
Dispensing systems can support the physician on a number of levels but will provide little assistance in the face of a drug seeker. The American Pain Foundation offers a detailed description of addiction in the write-up by Dr. Scott Fishman entitled Addiction.
My next post will talk about managing drug seekers.
