Identifying and Managing Drug Seekers – Part 2

In an EMS Magazine article by Greg Friese, Randal Wojciehoski and Amanda Friese, they discuss ways to identify and deal with drug seekers.  According to their article, common “techniques” seen by EMS providers include:

  • “I have tooth pain, and I am unable to see my dentist.” Oral exam
    findings show no swelling, abscess, bleeding gums, damaged teeth,
    swelling or point of tenderness.
  • “I have an old war wound with shrapnel still embedded in my bones.” X-rays are negative.
  • “I am new to the area and cannot get to see a doctor” or “I have an
    appointment next week, but need something to get me through the
  • “I was beaten up and they stole my Vicodin prescription I got yesterday.”
  • “My insurance only pays if a prescription is for multiple refills or more than 50 tablets.”

How should they be managed in a pharmaceutical dispensing environment?  The DEA offers some tips for dealing with drug seekers:

  • perform a thorough examination
    appropriate to the condition.
  • document examination results and
    questions you asked the patient.
  • request picture I.D., or other I.D.
    and Social Security number. Photocopy these documents and include in
    the patient’s record.  
  • call a previous practitioner,
    pharmacist or hospital to confirm patient’s story.
  • confirm a telephone number, if
    provided by the patient.
  • confirm the current address at each
  • write prescriptions for limited

The DEA goes on to say that physicians should not write prescriptions just to “get rid of drug seeking patients”.  The intention is not to deny life enhancing medications when medically indicated.  However, the physician dispensing to the patient has a responsibility to recognize that drug seekers are dealing with a combination of issues and should be directed to help that is appropriate to their underlying problems.

For more information on addiction management or to find other resources for helping your patients, please visit the National Association for Addiction Professionals.

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