WhiteCoat

Drug Seekers Suck

This morning as I was leaving my shift, one of the local cops mentioned that they are having a real problem with Vicodin sales and use … in the high school. Kids strung out during classes. Must be a great learning experience.

Where do you think these teenagers are getting their stash?

Then there’s this article about a doctor who was sued for giving pain medications to a patient and not sufficiently warning the patient about its possible effects upon driving. (Hat Tip to Kevin, MD) Oral arguments and the opinion of the court are at this link.

Keep the above in mind as you read the following which happened a few days ago.

A lady with a previous history of chronic neck and back pain now comes in with frontal headaches for the past month. Of course, her pain is a 10 on a 1-10 scale. She gets dizzy at times when she stands. Sometimes she gets nauseous. She says that she has vomited twice in the past 3 days. She used to take Vicodin for her back and neck pain, but she’s out of them now. I look through her old charts. She seems to like Dilaudid and Vicodin.

It’s a busy shift, so she had to wait for a couple of hours. When I walk in the room, she’s laying on the bed with her arms folded. She seems upset with the wait, but she’s playing the “nice” card, I can just tell. She’s sizing me up from in between those fingers over her eyes. Very polite. Says “thank you.” Compliments me on being so nice even though we’re so busy. I engage in some small talk with her and she actually is a nice lady. The little voice in back of my head is literally kicking me in the mastoid right now. “Hey! WhiteCoat! Don’t be a sucker. She may be nice, but remember her history! Being overly “nice” is page 2 of the drug seeker’s handbook!”

Since her headaches are a “new” complaint, I examine her from head to toe. No fever. No sinus pressure. No temporal arteritis. Fundi normal. No photophobia. No meningeal signs. No abdominal problems. No focal neurologic deficits. Oh, by the way, she still has that chronic pain in her back. Can’t find anything abnormal on her exam other than her “10 out of 10″ pain.

I don’t care how nice she is, she isn’t getting Dilaudid. We give her some Phenergan for her nausea and some Imitrex for her headache. Her headache improves to a 5 out of 10.

“By the way, doctor, my head still hurts. Could you please give me something else for pain?”
“Absolutely,” I tell her. “But it isn’t going to start with the letter ‘D,'” I think to myself.

We give her some Toradol. Her pain is down to a 2 of 10. “See, lady?” I think to myself, “you don’t need narcotics to get rid of your pain.”

When we tell her that we’re going to discharge her, she is actually grateful. She thanks everyone for being so nice. “Kill ‘em with kindness.” That’s page 3 in the drug seeker’s handbook. Well it worked. I sent her home with some Imitrex, Phenergan, and a couple of days worth of narcotics. The little voice in my head pulled the otoscope off of the holder and whacked me in the back of the neck with it. What a sucker I am.

That’s not the end of the story, though.

Two days later she’s back. Of course there’s another doc working that day. Divide and conquer — I think that’s page 6 in the drug-seeker’s handbook. Now it’s the sob story. The pain medications aren’t helping. Her head hurts. She’s vomiting more. Her doctor doesn’t have an open appointment. Oh, and now she fell and hit her head before her last ER visit, but forgot to tell the ER doc. Her neck hurts from the fall, now. Just to add to the drama, she’s acting like she’s confused. It isn’t January 2008, it’s really January 2007, “isn’t it?”

“Oh well, what the heck,” the ED physician thinks, “why not irradiate her body a little more?” So he orders a CT scan of her head.

ct-head.jpg

Brain cancer. Multiple metastases. Poor prognosis. As in she’s going to die soon.

This was one of those “Hey, you remember that patient …” moments for me when I came to work for my next shift. People were knocking each other over when I walked in just to tell me.

At first, I felt horrible about considering that she could be a drug seeker. But I got her out of pain when she came to see me. At least that’s how I rationalized it to myself.

Then I felt bad for not doing the CT scan when she came to see me three days prior. Was there really an indication for ordering it? Maybe, maybe not. Just like the Super Bowl, everyone can always sit back and second guess what might have happened if ….

Another rationalization.

All these warnings from our malpractice insurers about saying “sorry” as an admission of guilt have me too afraid to just walk upstairs to the floor, sit on the side of her bed, and ask her how she’s doing. I genuinely feel bad for what she’s going through. The little voice in back of my head started to mumble something. I grabbed him and whipped him against the wall. Maybe he’ll just shut the hell up for a while.

Maybe my human side will win over my chicken shit doctor side and I’ll hit the 4th floor button on the elevator after my next shift. Then again, maybe I’ll procrastinate long enough and she’ll be discharged.

When people complain that doctors don’t want to treat their pain in the ED, this is a perfect example of what emergency physicians and nurses go through every day. Where do we draw the line? How likely is someone to abuse the prescriptions we give them? Do I risk putting more drugs out on the street? Or do I risk not helping someone truly in pain? All we have to go by is someone’s history … just in case you were wondering, drug seekers lie.

It scares the hell out of me that a prescription I write could some day be sold to my own kids and start them on the road to drug addiction. Yet it scares me just as much that I could let another person suffer in pain because I was too afraid to write her a prescription for narcotics.

And the public wonders why we think drug seekers suck.

101 Responses to “Drug Seekers Suck”

  1. Dr. Greenbbs says:

    and i’ll be ordering head CT’s for all my headaches that come in for the next little bit.

    EEK!

  2. scalpel says:

    You relieved her pain. You treated her appropriately. The 2 day delay in diagnosis wasn’t medically significant. I don’t think she would have much chance of success even if she did sue you. Now if she’d waited three months to return…..eek indeed.

    That’s what bothered me. What if ….

    I’d be more worried if I’d seen her in the ER during the previous few months before the cancer was diagnosed but when it might have been more treatable if caught early. Any single mention of headache anywhere in the chart is going to be cause for a settlement. Vomiting, paresthesias, or “weakness” is going to be good for a NPDB listing too. That sucks.

    I don’t know whether I’d go see her upstairs either. Probably not.

    I didn’t. But now I wish I did.

  3. Nurse K says:

    10/10 pain with no neuro deficits? For the purposes of ordering a CT scan: YAWWWWWWWWWWN. That’s why everyone gets a follow-up provider listed on their d/c instructions and that little “we treated you on an emergency basis only” blurb, no? Now, if she presented with a first-time seizure, that would be a different story.

    Now she’ll get all the narcs she wants.

    • RC says:

      “Now she’ll get all the narcs she wants.”

      That’s a really really horrible thing to say.

      • mj Young says:

        You do NOT belong practicing medicine or in any other field where life and death decisions and empathy are required. You belong counting your dollars from taking advantage of the ill, poor elderly.and defenseless- maybe housing scams?
        When your time comes for serious and painful illness, I hope your doctor has your attitude and your suffering is very long!

      • mj Young says:

        The article Top 10 Reasons Not To Practice Medicine in FLORIDA was intriguing.

        However,few doctors who purport to practice medicine in Florida, do actually practice medicine for the well being of patients and advancement of ethical medical practices.

        They come to a beautiful paradise at young ages to follow the Medicare and retiree money and get wealthy without putting in the long hours of the truly dedicated physicians in other areas, research better methodology to ensure proper, empathetic care of patients.

        FIRST – DO NO HARM

        REMEMBER The Hippocratic Oath ?

        Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must:

        Make the care of your patient your first concern.
        Protect and promote the health of patients and the public.

        Provide a good standard of practice and care:
        Keep your professional knowledge and skills up to date.
        Recognise and work within the limits of your competence.
        Work with colleagues in the ways that best serve patients’ interests.
        Treat patients as individuals and respect their dignity:
        Treat patients politely and considerately.
        Respect patients’ right to confidentiality.
        Work in partnership with patients:
        Listen to patients and respond to their concerns and preferences.
        Give patients the information they want or need in a way they can understand.
        Respect patients’ right to reach decisions with you about their treatment and care.
        Support patients in caring for themselves to improve and maintain their health.
        Be honest and open and act with integrity:
        Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk.
        Never discriminate unfairly against patients or colleagues.
        Never abuse your patients’ trust in you or the public’s trust in the profession.

        This does NOT describe the average Florida doctor

    • Violet says:

      This comment actually made me cry. I had numerous ER visits for over a year, complaining of chest pain. I was young, so they said I was crazy. My own doctor referred me to a psychiatrist. A new doctor later that actually did real tests, diagnosed me with not one..but two heart complications. I live with this forever. Happens to me again, several times. I’m refused pain medication because I guess I fit that profile of a drug seeker, I’m young and it seems impossible that I could have all these health complications, and of course my blood work is fine. For 10 years now, I’ve had to deal with doctors and nurses treating me like I’m not worth anything. I never even took narcotics or pain medicine until I was in severe pain. I had uterine cancer, and it took a doctor to actually look to find it. I can’t have anymore children because it was too late to do anything besides completely remove my uterus. What do people like me do? There was a time when a doctor couldn’t find what was wrong with me, so he dismissed me as a drug seeker. The only hope I had for pain relief was ER visits. After my surgery I was just fine, no more pain..no need for pain medicine. People like us, go because we are asking for help. Do you know what its like to go to multiple doctors, do multiple tests but they don’t even remember your name on the fifth visit and tell you your pain is caused by a surgery you’ve never had. I do..I’ve lived it.

  4. TK says:

    Wow – that is a rough story. Still, not all headaches need a CT in the ED as well all know. The important thing I think is that she was referred to a neurologist for the new headaches. Small mets would not have even showed up on CT and would have needed an MRI (which routinely can’t be ordered from the ED).

  5. katherine says:

    thanks for your blog. I am a NICU doc. It is good to hear others voice the unvoiced worries about daily life in the trenches.

  6. ERMurse says:

    I work in a small ED that gets a high percentage of “drug seekers”. Most Docs take the attitude of give them a shot (one of the D drugs), narc rx, and get them out. One doc that I have grown to respect has taken the stance that the only way you will get narcs if you stay for a work-up. Otherwise its toradol or something similar. Even the ones that seem to be obvious seekers get a CT and in some cases LP for the headache if they do not have one documented in the past year. Guess what, he has found several significant finds like the one you had on people that were previously dismissed as seekers. The ones that truly seem to be faking for meds refuse the work-up and don’t come back when he is on. Work them up, great way to separate the wheat from the chaff.

  7. Yvonne ED RN says:

    You provided an accurate course of treatment based on the presenting symptoms and the response to the therapies thus administered. Defensive medicine is not Good Medicine. Usually a headache is just …a headache. Sometimes a Stegosaurus instead of a horse will be what we find when we hear hoofbeats. Thats the quirks of humanity. You did not make a mistake.

    Thanks for the support. :-)

  8. SarahW says:

    How likely is someone to abuse the prescriptions we give them? Do I risk putting more drugs out on the street? Or do I risk not helping someone truly in pain?

    I say the first two should not be considerations with much weight at all, if any.
    Drugs on the street are used by people who will use ANYthing, the population of addicts is a fairly stable percentage no matter what they get their paws on.

    I think it’s a mistake to put this gatekeeping role on physicians, who I see as more properly guiders for correct, safe use, and evaluation of pain’s causes, than gatekeepers from recreational use of medicine. It’s immoral to deny relief to the suffering just to make sure the undeserving don’t “get away” with something.

    That’s the point, though. How do we determine who is truly suffering and who is “undeserving”? Do we just write narcotic prescriptions for everyone? The resources spent on drug seeking patients are immense. Why reward such behavior?

    • karen says:

      i think an ER dr should beleive the patient and give them one prescription with a peice of paper telling them about a follow up Dr. and that wouldnt hurt, what is one prescripton?

  9. whitecap nurse says:

    I had an 18 year old girl with no medical history present with upper back pain after jumping rope the day before. Her pain got better after Toradol and Ativan. But at discharge, she said she couldn’t move her leg. I could have sworn she was just being a little drama queen, tearful, swaying from side to side and sinking to the floor when attempting to stand. Diagnosis later in the day – transverse myelitis. Another zebra!

  10. enrico says:

    It scares the hell out of me that a prescription I write could some day be sold to my own kids and start them on the road to drug addiction. Yet it scares me just as much that I could let another person suffer in pain because I was too afraid to write her a prescription for narcotics.

    Agree with another commenter that the first sentence is meaningless, provided that you script an appropriate amount of meds for them to follow up on the outside. 3 days worth of appropriately scripted Vicodin isn’t a drop in the street drug bucket either from either the abuser’s or seller’s POV. Your and my kids are/will be exposed to drugs guaranteed, so education and communication are the best defenses.

    Just like our justice system, sometimes guilty people go free because the system is skewed to protect the innocent, and “reasonable doubt” is the litmus test, not “proof.” Nobody–and I mean nobody–should suffer needlessly because of the influence drug seekers’ behavior. Anybody that disagrees with that statement in principle should get the hell out of medicine yesterday. In practice, legitimate legal worries cloud the line, obviously.

    I fear, however, that certain ED personnel care more about gloating, “I told you s/he was a seeker!” than “Thank God we caught this [fill in zebra].”


    If Vicodins go for $10/each on the street (which is what I have been told by the police in our town), selling 20 pills will make you more tax free money in one day than many Americans take home in a week. Multiply that times several medical providers per week and your “job” could become quite lucrative. Sure beats working at McDonalds.
    I agree that there are a lot of healthcare personnel who are too concerned with catching someone lying about their medication history. That concern sometimes clouds their judgment when treating patients in pain. That is the whole point of this post.
    Your legal analogy is a good one, but I think you take it too far. We don’t do away with the criminal law system because we never want to jail someone who is innocent. We just put appropriate safeguards in place to minimize the chances of convicting the innocent. We have to draw a line somewhere.
    Had someone come in a few days ago who said he only got medications from one pharmacy and one doc. We called around to several pharmacies and he got medications at all of them from six different physicians. Should we just toss him a script for a few days of Percocet on the possibility that he really could be suffering needlessly?

    • Kathy Kooper says:

      Enrico!
      Most of those drugs on the street never went through the Dr. to patient system! Pain patients had nothing to do with it! The narcotics were sold out of the ware houses! They left this information out! They were “Stolen” by ware house workers making minimum wage over the course of several years! Walgreens and CVS did not consider it worth putting in security! Walgreens was fined 80 Million for this “lack of oversight” The DEA lied about this and blamed the legitimate pain patients. It is ironic! If I were diagnosed correctly I would not be on pain meds for the rest of my life!

  11. girlvet says:

    This is what makes ER medicine so tough.

  12. Dr. Val says:

    I totally sympathize. This was hard. The one nagging issue – the complaint of vomiting. I don’t often find that drug seekers add that in to their stories… but the chronic back and neck pain would make most docs suspicious of drug seeking behavior.

    • ThomasPaine says:

      Have to say that you must not work ER medicine, Dr. Val. It is not uncommon to find patients sticking their own fingers down their own throats (when staff doesn’t appear to be present) in order to provide “evidence” they are really sick. Hard to believe, I know, but have personally witnessed this on multiple occasions.
      There was Munchausen before there was Munchausen-By-Proxy.
      However, I agree we cannot let this alter appropriate care. The sense of self-righteous accomplishment achieved by proving justified 999 times out of a thousand will be utterly, overwhelmingly, and devastatingly eclipsed by the one we pre judge incorrectly and cause prolonged suffering or, worse, harm.
      The struggle is to maintain a Zen-like, Beginner’s Mind, which incorporates training and experience, but views each patient with a fresh, unprejudiced, lens. There is a reason medicine is a practice.

  13. Patrick says:

    Spot on, Enrico!

  14. jerry says:

    Don’t sweat it. Like Scalpel said, the 2day delay does not make an inkling of difference.

    Impossible to be 100% sensitive and specific in distinguishing the addict from the medical problem, and often they coexist.

    Dr. Val: I find drug seekers vomit/dry heave/gag themselves all the time. It adds to the dramatic presentation. Or is part of their withdrawal.

    Enrico: Agree in large part. Always giving people what they want is not always best. Enabling someown with a self destructive habit and not ever attempting to intervene/confront them toward treatment is cowardly.

  15. EdDunkle says:

    Give the drug addicts their drugs! Who cares what they do to themselves? I doubt that many of them turn around and sell to others, especially high school kids with little money. And if they do, arrest them. Is there any hard data on this topic? (DEA propaganda does not count.)

    Why do so many scientifically trained doctors turn into baptist preachers when it comes to drugs? Drug addiction is a medical problem, not a mortal sin (am I confusing my religions? well, you get the idea.)

    If drug addiction is a medical problem, should I as a physician contribute to it further by prescribing medications to the addict? Do I next start buying bottles of scotch for alcoholics when they come in? Physicians have lost their licenses for prescribing narcotics to drug addicts that later died.
    When people complain about lack of resources and increased costs, drug seeking behavior plays a significant part to those problems. See this post and this article.

    • Linda says:

      I do sympathize with doctors that it is a problem and the government, DEA, being involved in the doctor business is part of it. I think the key is the people that get enough drugs to kill a horse. However, a lot of people really are in pain, and who is to say what goes on in another person’s body. I think if a person is a regular drug seeker, and all test have been done to rule out anything major there meds should be cut into portions and they could only pick up for so many days. If they are really in pain, you might try varying pain meds, and give them drug holidays so they don’t build up tolerance. Our bodies naturally build up tolerance so they require higher doses to get the same effect. I dont’ take pain meds unless necessary, but I have a problem with NSAID’s. They give me ulcers and stomach problems, but that is one of the things listed for drug seeking behavior. People that have Lupus like symptoms, like I do, really have a problem. It is so bad around where i live I got labeled with DSB simply because I ask for something you see on TV all of the time and had taken it previously when I had trouble sleeping. I’ve probably taken it 3 months out of my whole life. I think the DEA really needs to get out of the doctor business because patients are dying and suffering needlessly because of them.

  16. LA says:

    Brain mets. Just curious… is the primary known yet?

    Not yet. Didn’t look at her inpatient chart and haven’t spoken to her PCP.

  17. arrrr says:

    EdDunkle: How about the more obvious point… giving them drugs encourages them to come back and annoy you again. Give them a 2 week course of Vicodin and they’ll be back in 5 days for another $10000 workup. And again. And again. And again. I remember a calculation about one homeless drugseeker who was estimated to have cost about 100,000 dollars in his attempts to get more opiates. Think about that for a second.

    Insert complaints about rising health care premiums.

  18. frodo441 says:

    Myself, having been a cancer patient seven years ago, experienced some if not a few more of these types of class two narcotics…I can’t tell how excruciating the pain in my ass was until I finally could get it cut out…and I was glad to see it go…I got the assumption from people dealing with pain med’s by experience that “pain management” became teaching patients to tolerate some of it with in reason if not find other modes of dealing with pain…

  19. Kraig says:

    I am a former drug addict, but I did not use the ER as a source. I was cut off by a few doctors, but I always found a way. When a person is addicted, they will go to any length. Please don’t feel like you did the right thing by denying meds to someone. I had a back up plan that was an old woman with cancer. I hated myself for breaking into her house, but if the doctor said “No” I had no choice.

    A doctor needs to form a relationship with the patient. If someone comes into the ER with pain, treat them. If non-narcotics don’t work, give them a narcotic. Make sure they come in for a follow up. If they don’t show, no more meds. Too many doctors, in my experience were simply aloof to a fellow human being in need. You might say that a junkie deserves withdrawal, but it is one of the most horrible experiences a person can endure. That is why you can’t stop addiction by not writing scripts.

    How about being honest? Ask the patient if they want a narcotic or if they want to find the root of their pain. If they only want a narc, give it to them and tell them never to come back.

    Finally, I can’t IMAGINE a drug addict getting a script and selling it to ANYONE, let alone a HS student. My meds only went to me and other people that I used with. If a teenager gets Vicodin it is 99% coming from someone’s mom, dad or grandparents medicine cabinet.

    • ThomasPaine says:

      I thought part of being a “former” addict was accepting responsibility for your actions. Saying, “I had no choice,” but to break into an old ladies home and steal her medications is a choice. And it is evil. Time to stop excusing the behavior as “no choice” simply because physicians were doing their job appropriately.
      If physicians wanted to be drug dealers they could have avoided a decade or two of sweat and training and simply gone to the nearest street corner.
      The first oath of a physician is to “Do no harm.” Giving inappropriate medication of any kind is indeed doing harm. It is neither ethical nor good medicine.
      As far as “imagining” a drug seeker selling scripts, many of the seekers have an entirely different substance of choice and sell scripts to get money for their preferred drug. If they want meth or crack, they sell opiates to get the money for the crack.
      While I am very libertarian in my views, and believe the drug laws in this country, and virtually every country, are Draconian and harmful, the practice of medicine is very clear in this respect. Doctors are not there to be your personal drug dispenser. They are there to determine the cause of problems and treat those problems appropriately.

      • BethD says:

        “We are not responsible for our disease, but we are responsible for our recovery.”

    • BD MD says:

      Seriously,

      What if everyone with a sore throat wants penicillin. Guess I should just give it to them?

      Show me some writhing and tears with 10/10 pain. Not texting that can’t be interrupted when the doc walks in.

      The ER isn’t a damn grocery store. I can’t read your mind to know who is scamming me. That is why it is only for emergency. Get a doc who knows you and stick with that.
      ER Docs get screwed if they are too compassionate or too mean…

      I’ve done both primary care and EM. I’m less likely to prescribe narcotics in the ED…Know why? I see people who can’t withstand one day of any discomfort. Who flutter their eyes and moan if you deflect a hair on their skin.

      Blame your neighbor…not me…

      People go into primary care and EM because they want to help. Not for $$. That’s ophtho and radiology. But we get screwed for not doing “good” medicine on one hand and poor patient “satisfaction” on the other. This isn’t painting your house. A good deal of medicine is saying NO!! I can quote every bit of evidence but people want what they want…fast…and friendly…and….

      Well….NO!!!

      • Kathy Kooper says:

        No!

        well maybe you should get another job! I ma crippled because I was accused of being a drug seeker! I did not even want drugs, I wanted and x-ray which would have kept me from permanent nerve damage and a lifelong dependence on pain meds!!! BTW my Doctors either misdiagnosed me r were “Unavailable” I had a couple I saw for years who could not return one phone call, or recall the phone call! jerks like you should go into Proctology where you belong!

      • BD MD says:

        This supports what every doc on this site is saying…That your opinions and behavior are utterly not based on fact…

        As I proposed…let’s video all these interactions…Only to be retrieved when these issues arise.

        I care…I understand pain…professionally…personally…But it breaks my professional soul to be periodically used, criticized, and blamed when bad things happen…and they will…despite all my training, experience, and efforts, and emotion that I put out there.

        The real ugliness always comes out…Someone must of course be blamed for the suffering…Not that suffering is doled out by a power beyond simple humans…

        See what I see…in just one day….

        :)

      • kathy Cooper says:

        Facts!
        The misdiagnosing Dr. was factually arrested for cocaine possession and procuring a Prostitute, this was after my incident, but he could have been on a multi day coke bender! Fact The Hospital Settled several lawsuits involving his treatment of women in the ER. Fact I have pounds of imaging documenting my spinal issues! fact! I go in ofr an C-spine MRI next week to see of the implant in my neck, which was misdiagnosed as a “Hysterical” i.e.. Woman’s problem, has deteriorated! Fact! My surgeries were done long after nerve damage became permanent! Facts! I have boxes of Facts! Thousands of dollars of imaging, and constant chronic pain! Those are facts! Boxes of em!

      • JadeDustEyes says:

        I completely support what you are saying, BD. I can honestly say that I can count on one hand the times I have truly had 10 out of 10 pain, & during those times, I didn’t care WHAT it took to take away the pain! In fact, one of the HUGE headaches that had me calling 911 was so severe & came on so quickly that I was convinced my head would explode & I honestly wished to pass out, the agony was so horrible. When they got me to hospital, they did all the scans & LP & found nothing of note (thank God). As for asking for narcotics, I never did, as I was just so thankful the headache had finally subsided. I believe patients grossly overuse the “10” rating on the pain scale, & that messes it up for everyone else.

  20. Lisa says:

    She’s sizing me up from in between those fingers over her eyes. Very polite. Says “thank you.” Compliments me on being so nice even though we’re so busy. I engage in some small talk with her and she actually is a nice lady.

    I bet she would appreciate your concern. I don’t have as much to lose as you have on the line, but I know as a previously misdiagnosed & “nice lady” that it would probably mean quite a bit to her. Even if just to say, “I just wanted to check on you and see how you were doing.”

  21. jesslev says:

    Interesting stuff! I think you should go see her too!

  22. peggy says:

    “I had a back up plan that was an old woman with cancer. I hated myself for breaking into her house, but if the doctor said “No” I had no choice.”

    Had no choice? Please, Kraig, stop lying. You always have a choice. Getting off those street drugs will cause you the equivalent of a really bad case of the flu for two or three weeks, max. Those who use, like it and simply don’t want to not use. THAT is a moral problem. There’s an entire industry employing thousands who would all be out of work if they didn’t go along with the myth that drug addiction is a medical problem, not a moral problem. It’s a character problem, for sure….witness your witless statement of having “no choice” but to steal pain meds from a woman with cancer.

    • JadeDustEyes says:

      Let me ask you something. Have you ever been addicted to opiates, legal or illegal? Have you ever gone through the horrible withdrawal experience when those opiates are taken away or are not available? No? I didn’t think so. Much, much worse than ‘a really bad case of the flu.’ Take a hammer, smash both arms & legs, pound at your torso, turn the heat all the way up until it’s like a sauna, then the A/C until it freezes the sweat on your skin, drink some ipecac & pule every hour on the hour, take a whole bottle of stimulant laxative & empty your bowels constantly, with cramping in between, dehydrate severely, & take a steady dose of too much caffeine so your nerves are twisted & you can’t sleep. Then repeat over & over again for as long as it takes for your system to cleanse…could be 10 days, could be 28. Doesn’t seem to matter when each minute stretches for eternity & guess what? You’re scum. Reviled. Vilified.

      As a pain patient ‘taken’ off my meds, I know how this feels. And yes there is a rare occasion when they are lost or stolen, as happened to me. I stuck it out & didn’t bother with the ED…what’s the point if I’m going to be crapped on & blackballed. Drug addiction is a medical AND psychological issue…the moral issue enters only when a crime is committed and/or someone is wronged. And addicts don’t end up continuing to take opiates because it ‘feels Good’s and they just don’t want to stop. By this point, a dose is needed just to get straight & feel normal, stave off those wicked withdrawals. So take your judge’s robes off. While I would certainly never condone breaking into someone’s house to steal opiates, I understand the pain these people are going through.

  23. Steph says:

    Drug seekers do suck. I can’t speak to what it feels like to have a diagnosis like that come back after you’ve discharged a patient. But speaking as a patient who is dealing with the frustration of looking for a doctor that won’t automatically assume that of me, your attitude is something I would be pleased to have. I’m glad to see that even though you see drug seekers every day, you’re still willing to accept that people can be in pain and look for ways to treat that pain.

    I’ve had a lot of doctors misdiagnose me. I’ve had a lot miss the “oh, by the way, you’ll probably die because of this” signs. That never upset me; there wasn’t anything they could have done differently if they had been right. But I have always remembered and truly valued the doctors, nurses, etc., that took the time to treat me as a person, to listen to me and do their best to help me. It sounds like you did that for this patient, regardless of what the little voice in the back of your head was saying, and that really can be more meaningful than you know.


    Thank you. I looked at your blog and hope that you continue it. There are a lot of doctors – me included – who could learn a lot from you.

  24. SeaSpray says:

    What a powerful post!

    The following is part of a quote I wrote that I keep on my
    sidebar: “Sometimes in life, all we can do is our best and it’s not always going to be someone else’s best, but it is our best at the time and so we need to be forgiving of ourselves when necessary.” I omitted part of it but I think the rest of it applies here.

    Also and I don’t know if it makes a difference because you indicated she is terminal, but maybe she needed to become an inpatient and if you had given her the drugs they may have delayed her getting the more important treatment she needs or possibly it would’ve been too late to get her affairs in order if she hasn’t already done that.

    Maybe I am wrong but I really believe we are meant to meet certain people so certain events can play out in our lives for whatever reason.

    You docs ARE between a rock and a hard place with these decisions.

    You were nice to her and she appreciated it and told you. She couldn’t hear your little voice. You have that voice for a reason. You need to be discerning in your profession. You know some ED staff would have totally blown her off. You didn’t. You worked her up and didn’t find any reason to order a CT. BTW…remember your posts regarding excessive radiation?

    Between a rock and a hard place…yep!

  25. LawyerMom says:

    I read this and my first thought was, “I bet some plaintiff’s lawyer would like to read portions of this post to a jury (or, worse yet, make YOU read them) if this case ever went to trial.” (Assuming, of course, the lawyer was competent enough to link you/your hospital with the blog, a big assumption.) It’s hard to imagine that 2 days would make any difference whatsoever, but was this the first time she had mentioned her headaches at your hospital? Remember Dr. Flea?

    I frequently think about whether something I write will some day be used against me. Those who have ulterior motives can always twist something someone says into something that meets their needs (i.e. reading “portions of the post to a jury”). But I’m not going to bow to a fear of what some lawyer “might” do. If we all become paralyzed from fear of lawsuits, no one would ever write another blog entry.
    This was the first presentation of the patient for headaches. If the case ever went to suit and some attorney wants to try to grill me about the difficulties physicians have dealing with drug seeking patients, I wouldn’t feel the least bit uncomfortable about reading the entire passage to a jury.

  26. Susannah says:

    Replying to an old blog post.

    Sorry but i get upset. I am a chronic pain sufferer. By all means, it’s rarely a 10, but i am at 7-8 on a daily basis.

    Before i finally found proper main manegement from a wonderful pain doctor i had to go to the ED many times. And Most doctors have been happy to help me, usually one or two Dilaudid shots and sent home with Tramadol (I asked for the Tramadol because it helped for years) I am now on the Fentanyl Patch 50mcg and Roxicodone 15 for breakthrough pain. Tramadol does not help anymore.

    Anyway, on to my reason for posting this late reply. Like i said most Doctors in the ED were wonderful but a few times I got some Doctors who thought i was drug seeking and i can’t tell you how frustrating and heart breaking it is to have a doctor look at you like you are an addict when you are not and you are in horrible pain.

    I don’t understand why some ED doctors are not compassionate about Chronic pain patients and why so many of you think we are drug seekers when we are not. Yes, i understand you probably see a few drug seekers a day and i understand it how frustrating that gets for you, but imagine how frustrating it is for someone in horrible pain and being looked at like they are an addict.

    I think some ED doctors out there need to go back to school just for this sort of thing. Most people who go to the ED ARE NOT DRUG SEEKERS. Most of them are good citizens and good people.

    Next time you are treating a chornic pain patient, try to have a little more compassion and don’t assume just because someone has been there 5 times in the last 6 months for chronic pain that they are drug seekers!!! Next time you or a loved one is in pain, remember… what if it was them going to the ED for REAL PAIN and they we’re turned away because the ED doctor thought they were a drug seeker.

    This all makes me so mad. It’s not fair. But, at the same time i have had some great ED doctors who treated me wonderfully. But, once in a while I’d get that young whipper-snapper doctor who thought he was going to save the world by turning away someone who he mis diagnosed as a drug seeker!!!!

    • BD MD says:

      Yeah? Somehow common sense and personal responsibility never comes up.

      Get one doc and stick with them. Don’t show up in the ED for chronic pain.

      I have chronic pain and know what it’s like.

      I’d love to have a video camera in my room. That would reveal the truth…

      The nastiness, the demanding, the drama…

      That’s evidence my friends. This is all he said, she said.

      Let’s just use video evidence in every room for the trialS…

      Know what? Many more docs who be vindicated and not vilified.

      Chronic pain is not an emergency medicine issue. Have a plan in place. Don’t “lose” your medicines (why does no one lose blood pressure or diabetes medicines)…

      I have chronic pain. I work in an ED.

      Feel free to follow me with a camera…and all my colleagues.

      This isn’t a grocery store. We do excellent medicine.

      I wish all ED’s had recorded visits saved in a secure vault for when the doc gets sued or complained about being mean…

      The truth will set everyone free.

      And save a lot of money.

      In my old clinic patients swore they were told things on the phone. Cussed out my staff. When we played back the recording and THEY were flat wrong…it was STILL our fault!!!

      God Bless America!!

      Bug me/video me…I care…I practice good medicine. Patient’s can be horrible…then claim they are the victim….I am unfeeling…incompetent…

      All should see what really happens…

      Maybe a reality show? The people on COPS? They show up in the ED!!

      How about a little evidence in this medicine!!

      • BethD says:

        I routinely lose medications, which are NOT narcotics, just because I have a terrible memory. Sometimes I find them, sometimes I don’t. I believe that there are a LOT of people who claim to have “lost” their pain meds, but you can’t say people don’t lose their Toradol or their Elavil.

  27. […] Is it not true that GruntDoc, Scalpel, Nurse K, Whitecoat, Shadowfax, and other medbloggers are always lamenting the large number of drug seekers […]

  28. Greg says:

    I was that guy for awhile.
    The polite well dressed professional middle class guy in your E.R. complaining of rib pain. Well, lying about it anyway. I would say that I “slipped on the ice and just came down on a parking curb. Darndest thing, but no bruising, so I just put up with the pain for a few days until my wife said I could have a cracked rib and should go see a Dr.”
    Of course it’s Sunday or 3 in the morning and “it just hurts to breath a bit, or cough, and it sure would be nice to get some sleep.”
    I would even make it look like what I would really like was a script for a just few days of sleep meds.
    I would be nice to the nurses. I would flinch as you, the Dr., would push on my ribcage. I would be “splinting” as one Dr. called it. Sitting up real straight on the table as if something hurt.
    After a few X-Rays and some re-assurance that I would be O.K. , I was on my way out the door with a script for some hydros.
    It never failed.
    I’m sorry.
    I admired all of you. I respected you as well. Yet I still burned you.
    I was probably on day 2 or 3 of withdrawals because my dealer was temporarily out.
    He got his merchandise from guys that were legit patients that just didn’t like the pills that the Dr.s gave them as much as the money that they could make.
    I was a consumer. I never sold or gave away any thing prescribed to me. It was MINE.
    The drugs that someone would try to sell to your child came from one of those many, many legit pain patients that are getting 90 to 120 10mg hydros (or maybe even oxys) a month and selling them off.
    The seekers you see are in desperation for a 3-5 day fix until the supply returns. It always goes in cycles. Those scripts never see the street. Ever. Unless that seeker gets ripped off by some neighborhood kids.
    Now that I’m clean I try not to think about what I did to you people. It hurts too much. The lying really does suck. I hated myself. It’s not a happy addiction. I spent my time, money, and energy on not just chasing a buzz, but avoiding being sick from withdrawals.
    I never did break into any old ladies houses.
    But the thought had crossed my mind a few times.
    I am so lucky to have been helped by a compassionate circle of friends and family. Say a prayer for me that I can stay out of that miserable existence. And the next time I’m in your E.R. It will be because I ‘should’ be there. And I hope that I will be able to say, right off the bat, that I am a recovering addict to opiates.
    Please don’t worry about the seekers scripts getting out on the street.
    Please remember that the pills on the street came from those legit pain patients with the endless monthly supply.
    Money is stronger then pain for those individuals.

    For the first time in a long time, I am not lying to Doctors

    I kind of like it.

    Once again…
    Sorry I burned you guys.

    Greg

    I am truly glad for you that you were able to beat the demons inside of you. Keep up the good fight because I know that those demons will always be nipping at your heels.
    Would you e-mail me (whitecoatrants-at-gmail.com)? I have something to ask you privately.
    Thanks
    WC

    • CystineStoner says:

      “Please remember that the pills on the street came from those legit pain patients with the endless monthly supply.
      Money is stronger then pain for those individuals.”

      I am just insulted and disgusted, even though I know this could be true. But to say it like all chronic pain patients sell their pain medication, is just unfair.

      I have a rare kidney disease called Cystinuria. My body makes cystine stones DAILY. I can pass 50 or more stones in a 24 hour period if I’m having a bad day. There is no cure for Cystinuria and the current therapies, Thiola and Pen-D, are not very effective. I’ve had more surgeries for stone removals and blocked ureters than I can count on both of my hands. I live with constant pain in my kidneys, more so in my left. I just moved to Mid-MO in July and I am having the hardest time finding a doctor to believe me. Yes, I’ve been in and out of the ER for pain because my new primary doctor wouldn’t really do much about my pain and other symptoms even though my previous doctors mailed her my full medical history, and let me tell you it is HUGE!

      First, I must explain. I was on 15mg oxycodone three to four times a day, for 3 years, in AZ. All my doctors trusted me. I never asked for refills early. Most of the time I was using 120 tablets for two months, sometimes three, instead of every month. But when the pain was horrible from an increase in stone production, infections, blockages, surgeries, I would definitely need the 120 a month. AND I would never give my medication to anyone else. Not only is it very addictive but it’s dangerous!

      Anyway, I moved to MO thinking doctors would help me with my disease like all the other doctors I’ve seen in AZ and NV did. BUT since July, I’ve only seen TWO doctors who have truly helped me and believed that I was in pain. Just days before going into the ER, I begged, cried, and even argued with my new primary doctor for some kind of relief. I had a UTI ten days before I first saw her, was treated for the infection by an urgent care doctor and given 5mg vicodin for pain. I was happy to receive ANYTHING for pain, even if it was something that didn’t help very well. Going from 15mg oxycodone to 5mg vicodin for REAL pain is hard! I really felt like I was going to die. So at this first visit with my new doctor, she doesn’t seem too worried about my disease, but tells me she can’t help with my chronic pain and tells me she’ll give me something to last until my appointment with a pain doctor, which is a month away. She said she will give me a 30 day supply of oxycodone 10mg and said she’ll follow up with me in a few days if my nausea and pain doesn’t seem under control. She makes appointments for a urologist, it’s a month away, great! I get handed a prescription for (30) 10mg oxycodone but it says to take half to one every 12 hours for pain. OK, how is this supposed to help with pain for a whole month? I figure I will just have to suffer because she refuses to write anything more than that. At least she gave me something, right? I did do a UA and I did tell her I felt like I had another UTI or kidney infection. She said follow up later. OK. A miserable week goes by, withdrawals along with passing stones and not enough pain meds, and these other horrible symptoms. Fever, chills, sweats, nausea, vomiting, PAIN. I end up in the ER the same day she tells me she can no longer help me because I am asking for pain meds. I kept calling the clinic asking for HELP, not just proper pain management. I knew something was wrong. And in the ER the doctor is shocked that I was treated so poorly by all these doctors and nurses. I’m dehydrated, blood in urine, kidney infection, stones in my kidneys, and in the collection cup is a lot of “gravel” and some small stones. I’ve been to the same hospital once before and went to a different hospital before that also. Both times I was treated like a drug seeker. I was even told that “cystinuria isn’t a real disease, it just means I have stones sometimes. And stones in the kidneys don’t hurt so I should do my homework next time.” Then given 12 to 20 tablets of 5mg oxycodone for “maintenance” to be taken every 12 hours, when this whole time I was right and had an infection. The pain was BAD because of the infection and passing stones constantly. So why the judgement as soon as I walk through those doors? Even my previous primary doctor in AZ was trying to call doctors and have them help me, explaining this weird disease to them. But, no. They wrote me off as a drug seeker and gave me a few pills to keep the withdrawals away. I admit, I burned through those pills every week. Taking one or two 5mg’s every 4 hours for REAL severe pain because no one was really helping. Even as I sit here now, with no narcotics in my system, using Toradol for pain (even though it doesn’t even take the headache away) and feeling like another infection is here, I can’t find a doctor who wants to help me. So, will I end up back in the ER asking for relief? Most likely, yes. I’m still waiting for my appointments, they’re next week, finally! But for now, I’m left here to suffer and be sick. Infection? Blockage? Maybe. I won’t know until next week.

      Please, try your very best to help people who are ill and really need help. Pain is an indicator that something is wrong. I’ve never heard “stones in the kidneys don’t hurt” until I moved here. I am frequently in contact with the director of research at NYU for Cystinuria. He has provided us stone suffers with enough medical research that, yes, pain is real and stones IN the kidneys DO hurt! Especially after having so many surgeries, infections, blockages, and stones. I even have crystals on the OUTSIDE of my left kidney. Painful? **** YES! So, please, listen when someone says there is something wrong. Even an addict can have kidney stones or a blood clot! Pain is pain.

    • Terri says:

      I agree with everything you said greg I was addicted to vic’s for years and i bought them from a guy who had alot of older “friends” every one of them got scripts every month for 120 to 150.

  29. Teresa says:

    All these warnings from our malpractice insurers about saying “sorry” as an admission of guilt have me too afraid to just walk upstairs to the floor, sit on the side of her bed, and ask her how she’s doing. I genuinely feel bad for what she’s going through. The little voice in back of my head started to mumble something. I grabbed him and whipped him against the wall. Maybe he’ll just shut the hell up for a while.

    Maybe you should be listening to the little voice instead of the insurance company. There was a very interesting article in the NY Times a few days ago suggesting that an apology and admission of wrong actually reduce the overall cost of medical mistakes. Most states have made such actions on the part of doctors inadmissible in court. You should check your state laws; it might be a comfort to you.

    My own guess is that lawyers don’t want you to admit wrong, not just because it can be hard to defend (if it were admissible), but because if the doctor solves the problem with an apology, the need for the lawyers goes away. Think about it–by soothing the patient with a soft answer, you’re cutting the lawyer out of business.

    We need more sophisticated juries. The average person in this country does not appreciate how much medicine is judgment and art rather than predictable treatment courses, especially in today’s rushed up environment.

    And the problem with all juries in all cases is that hindsight is 20/20, and when you have unlimited time to think about something, it is easier to come to the right conclusion. Most liability cases involve fairly quick decisions on the part of the defendant. You accidently hit someone with your car–how much time did you have to think and react to the situation? Yet the jury can take as many days as they like figuring out just how, in that 2 seconds you had, you could have avoided hitting them.

  30. Kayla says:

    My name is “Kayla”, and I am what some would call a “functional addict”. In reality, I am as dysfunctional as they come. I am a real person with real problems, who obviously does not know how to deal with them. My purpose in stating these things is not for self-gratification, but rather to put my problems out in the open, as this has been a secret for far too long. They say the first step to recovery is admitting that you have a problem. I see many blogs by ER and ED doctors and nurses about the drug seekers they see on a daily basis. Part of me wants to be angry at them, for being so crass and uncaring, but I can also see their perspective, too. They are real people as well, with real problems, but they aren’t popping hydros just to get through the day now are they? NO! I envy them. I envy the people who go through life on a daily basis with a smile on their face without needing a chemical to alter them enough to make them think they are happy. Are there resources available, medicines available to help this. I know substituting one drug for another is not the answer but at this point I am scared shitless. I need help and I know it. I do not want to become a statistic in your emergency room, as I have never had to drug seek in the ER.

  31. Lilianna says:

    Ah doctor, doctor – you know that us chronic pain patients hate the term “drug seeker.” We prefer pain-relief seeker. Even if you don’t believe us. I won’t go into that – i’m pretty sure you’ve been to my blog so you know how I feel about doctors undertreating chronic pain.

    I was just wondering how it came out with the patient. I don’t know if it helps any but among other pain complaints, I was suffering from chronic headaches (which I didn’t realize were migraines and I was pouring OTC sinus medicines down my throat), dizziness, blind spots, visual disturbances, nausea and vomiting and went to the emergency room a couple of times myself for it. Those doctors would just say headache (still, no one saying the word Migraine) and those doctors never gave me Toradol shots and they worked just fine. I was never given a MRI either. Couple months later….wait for it…..Central Retina Artery Stroke. But hey, my internal medicine doctor missed it too. It wasn’t until I was in my hospital bed with blood thinners running through an IV, that a neurologist said the word migraine. Migraine induced retinal artery stroke. Who knew? I was irritated that no one asked me How Much OTC sinus medicine I was taking until the neurologist – over 40 pills a week. Now I use midrin or Toradol shot if midrin doesn’t work.

    By the way, I dumped my internal medicine doctor after the stroke. Why, you might ask. Not because he missed the diagnosis. It was only because a couple of weeks passed and he didn’t give me the courtesy of a phone call. And no, I didn’t sue him. I’ve been misdiagnosed before, all with drastic consequences to me, but I realize I am the zebra.

    Those attorneys saw a windfall because…I hate to say it…a child was involved. Juries make decisions based on emotion, not facts. Superior Court judges, I read all the opinions and their decision wasn’t based on facts. Patients have a duty to be self-advocates and not put the public in jeopardy. Stupidity rearing its ugly head again.

    Lilianna

  32. Lilianna says:

    oops, I meant always gave me Toradol shots.

    Lilianna

  33. Kristina says:

    I read your blog often. As do I read other ones that were linked to yours. I actually stumbled across it while trying to learn exactly what a “drug-seeker” was. Unfortunately, I was labelled as one, and it cost my son’s life. I was pregnant. Reported to the ER numerous times because I felt as if I were dying, bleeding, cramping. Since I was not bleeding the first 6 times I went in there I guess they figured I told the blood to come out of there so that someone would believe me but they still didnt. I was sent home over and over again. 31.5 weeks pregnant and I was asleep in bed when my water broke. I had vag bleeding, cramping, and I do mean SEVERE cramping. I labored for 27 hrs before requiring an emergency c section. All this time, I was abrupting. I begged for an epidural. Unknown to me, the nurses had labeled me a drug-seeker. Well, I guess I was. I was in such pain that I couldnt see straight. I WANTED ANY DRUG THEY WOULD GIVE ME! I would have taken a hammer or iron skillet over the head if it would have knocked me out. My son required 20 minutes of cpr. he did come home, fed through a g tube, had HIE, many many problems, mechanically suctioned. I was urged by nurses at the NICU he was transferred to, that i needed to file suit against the hospital and nursing staff and my dr. Taboo huh? I never ratted these nurses out and I never would. How likely is a nurse who suggests you sue to get a job, eh? Well, I consulted an attorney. But no, I didnt follow through. And it took me reading your blog to make sense of some things. Initially I blamed insensitive and uneducated, crass, mean nurses and staff for killing my son. I was so angry at them. For calling me a drug seeker, at the expense of my child. Nothing could take away the pain of finding my sweet baby lifeless and blue, the blood already pooling to the side of his little face. NOTHING! I blame society! The drug seekers who swarm into your ER DAILY looking for drugs. They made this happen to me. They cause the medical field to doubt any one in pain, given the reaction. In hindsight, I guess I appeared to be looking for meds. I went in begging for them because I hurt sooooooo bad. Time after time after time. but even more, I wanted them to find out what was wrong, but it was too late. The people plagueing the ERs and other depts, made my life hell. They caused the medical staff to think my condition was not a true medical emergency, but rather a need for narcotics. I do understand why you get so angry and fed up with them.

    As much as my child deserves justice for his pain, me sueing will not fix this. I wish there was something that could be done, some way to have a magic ball and know who is faking and who isnt. If you did, maybe my life would be different. Damn those seekers, THEY killed my child.

    • M says:

      I am sorry for your loss. It was the doctors fault, not the seeker. They DOCTORS clumped you in with seekers, the DOCTOR didn’t do any of the tests they should have done, the DOCTOR didn’t listen to you. Just because a few seekers come in doesn’t give the doc any excuse to lump you in with them. Labor is a very painful process, and any doctor who doesn’t expect a pt to ask for pain meds shouldn’t be in medicine. The DOCTORS killed your son! In all honesty during my pregnancy they labeled me a seeker. When I pleaded for pain meds for my labor they refused and walked away from me. (I lost my son, he was stillborn).. I feel your pain and I understand why you feel the way you do, but your blaming the wrong people.

  34. bladdergirl says:

    Firstly I think its a hard thing to fess up like you have and admit your initial assumption was incorrect.
    That’s admirable. I wish all Medical professionals could do the same.
    My last consultant never acknowledged what she didn’t do for me as a patient and it nearly cost me my life. I don’t hate her, nor am I bitter and twisted.I just don’t want her near me again. I believe that Doctors are human, and its not about making mistakes its about things that just go pear shaped. Every human body is different, and you can’t always get it right.Doctors aren’t gods. The job is stressful(I was married to one)They too suffer human responses. Anaesthetists have a high rate of drug abuse and suicide, which is sad. No occupation is infallible. Drug seekers piss me off too, because I don’t want to be labelled either.

    I learned different ways to manage my pain. My last post I wrote highlights this. http://neo-conduit.blogspot.com/2008/09/pain-control.html

    I use distraction technique and clean my house up when in pain while grooving to music.

    What I do query though is does it mean your a drug seeker if your nice to the staff? That’s disconcerting as I would rather be respectful and genuine than get into full on yelling arguments like my EX Consultant did with me (and her other patients.

    My other issue is I tend to leave things too long, and actually got a bollocking for leaving infections too long and going into sepsis. I would be asymptomatic, then thinking I was getting a flu I would wait it out, not wanting to annoy E.D staff. I have a G.P who’s marvellous but due to my condition her hands are tied as it often requires specialist intervention.

    So should one stay calm polite, and respectful to staff and risk being labelled a junky when the medical condition may be life long? *Sigh*
    I’m confused.

  35. nogie1717 says:

    As a former drug addict, I find some of these posts to be right on point and others so far from the truth it makes me laugh.

    First, the post by SarahW
    “Drugs on the street are used by people who will use ANYthing, the population of addicts is a fairly stable percentage no matter what they get their paws on” is both sad and laughable. I was addicted to opioid pain killers, ie. Hydro and oxycodone, and later, Methadone. I would never use “just what I could get my hands on.” I disliked cocaine, meth, LSD, as well as other pharmaceuticals like Xanax, Soma, etc. The majority of narcotic (pain killer) addicts are exclusive to their drug of choice.

    To the doctors out here: Drug seekers who go through the effort of the ED are NOT going to sell their pills. They are looking for a way to eliminate withdrawals or that awful feeling that precedes them, the anticipation of WD’s. Most scripts from the ED would only last an addict half of a day. At the height of my use, I would take anywhere from 20 to 30 Vicodin a day. Say what you want about liver toxicity from the APAP. I don’t know why I didn’t fall victim, but I didn’t. A script of 10 hydrocodone will be one ‘buzz’ for a true addict. They won’t even get high off of it.

    In close, shortly before I admitted myself to a rehab facility, I went to a doctor (not an ED) and made up a sob story, literally, to get a few methadone. In my car was a gun. I didn’t know what I was going to do with it, but I was desperate. I probably would have robbed a pharmacy or killed myself or both if the Dr. hadn’t been kind enough to replace my “lost” pills. My advice is always do a work up, if they refuse, you refuse. Keep scripts small, write the number in longhand, and don’t be afraid to ask if the person needs help. During my addiction, most Dr.’s were coarse in their refusal of meds. Addicts don’t want to be the way they are, but the pain of withdrawal will drive them to desperate measures. Deep down, they want and NEED help. You could be their savior. Be objective in everything you do.

    I like the idea of asking a patient if they need help. I had a very rewarding experience with a lady who I busted, but who I then saw several times in the ED afterwards to help her get through her withdrawal.
    Thanks for sharing.

  36. steph says:

    i am a drug addict .never thought i would become one all started with a toothache so bad i wanted to put my head into a wall ! i got my first scrip for vicodin at the ER . it took my pain away but also liked the way it made me feel . i would do any thing to go back and not have taken that first pill. i want to be honest with my doctor and tell him i need help but im scared he will pretty much laugh in my face ! so coming from some one who is addicted to pain pills give people in pain non narcotics first . because you never know like i said before i never planed to become addicted it is my falt i keep taking them i have tried to stop but i cant deal with the withdraws . and its way to easy to buy them off the streets .

    I hope you get the help you need.

  37. TM says:

    To all er doc’s don’t give narcs.

  38. Benji says:

    The only reason I am even reading this web page is to get an idea of how doctors REALLY think about people going to the ER for pain relief. I am trying to deal with this chronic back pain without useing medication, but I don’t see any other way at this point. My main problem is that I am a young man (23) and as soon as I start talking about relief for pain, the doctor shuts down and labels me an addict. Since when does not wanting to be in pain denote you a drug addict? I have a strained back right now with a pain that will not go away, but I am honestly afraid to go see a doctor, because what happens when I pay them good money to just turn me away with a prescription that does nothing, or just some advice? I really don’t want to waste a doctors time when they could be treating someone with somthing more severe, but I woudn’t be wasting my time if I wasn’t in real pain. I have found that doctors are going to do whatever they think is best for you, and you no longer (if ever) have any say in what you think you need. I also can’t stand it when a doctor asks me, what would you like us to do, and my answer is “help me get rid of this pain” and their first response is “go home and take an ibuprofen”, are you kidding me?

    • Linda says:

      Never ignore back pain, I thought I had a pulled muscle, told an emergency room physician about it and he told me it would probably be better in a month, it finally became so bad I had to go to the doctor, she made an appointment for a chiropractor, then I ask her, feel my stomach and see if this is normal. I figured I was just getting a litte round belly like some older people, but it turned out to be an ovarian cyst the size of a honeydue melon. Back pain can be so much more than a strained muscle, always have it checked out for the cause. I had emergency surgery, and probably would have died, had I not caught it in time.

  39. unitygain says:

    Definitely a catch 22 between underprescribing and unwarranted suspicion at one end; license revocation and jail at the other.

    What I haven’t seen physicians do (that seems to be the logical choice) is to take a real position on the issue of chronic pain and push it via a union arrangement or cumulative legislative push by a majority of doctors.

    Either choose that treatment or erroring on the side of prescribing narcotics is in the best interest and run with it politically and legislatively, or decide that abstinence and suspicion is the best policy and run with that politically and legislatively.

    Obviously, treatment with possible collateral damage would be the preferred stance. Doctors are all aware of the problem yet only the PRN seems to be actually DOING anything legislatively to get the DEA out of medicine.

    Doctors UNITE, and DO SOMETHING TO HELP GET THE DEA OUT OF MEDICINE!

  40. Touchet says:

    This is what is happening to me. My doctor can’t see me for at least a week. I am in pain, all test have come back negative. The thing is, I don’t care about the pain killers. Sure they help…They help a lot. But I am willing to live in pain till they find what is wrong with me. I KNOW they think I am a “Drug Seeker” and that my symptoms are non existant.

    Did it ever occur to the medical establishment that “Drug Seekers” actually seek drugs cause they ARE IN PAIN! DUH! If you really think that the person has an addiction, treat them for that. Do a blood test. See if they have drugs in them. If you think they have a mental problem, refer them to a Shrink.

    I actually told the last doctor I saw to run every blood test he could think of. I HAD TO TELL him to do it. So sad the state of medicine today.

    • BD MD says:

      Docs almost always recognize real pain. You should see the drama and behavior in our offices! What if I came to your place of business and behaved like that??

      • kathy Cooper says:

        Nonsense BD MD!
        Doctors remain ignorant to pain and might only treat it in wealthy upstanding citizens! What a joke if you believe that you are delusional. Doctors misdiagnose up to one third of all visit pain ofr otherwise and get away with it! I have box full of misdiagnosis! I have had to be in agony and bite my tongue while a doctor makes ongoing idiotic and misogynistic remarks! How are people supposed to act
        t when they are in agony and are being patronized, and ignored?

  41. Ariel says:

    I think drug seekers must be the most selfish people that exist in a modern society. I am a primary care physician that can never get my REAL patients with REAL problems to see me within good time. I went through my schedule for the last three months and roughly estimated that up to 25% of my patients in one day can be of those who seek “establishment of care”, or whoose “doctor is on vacation”, or simply “didn’t treat me right”.

    Whenever ANYONE new patient or old specifically asks for a narcotic and mentions it with name, I put that in the chart as a medication I will NEVER give them. If they want it, then go back to their other doctor. He can’t be that bad if he was giving out candy to begin with. This policy of mine has actually made some of the other docs somewhat bagry with me, because now these SOB’s show up at their doors instead.

    At the same time, I have people with MS, CHF, Cancer or what have you that cannot get an appointment because these ***** have taken up precious time.

    Sorry drug seekrs, but you guys have collectively forced me into this situation. Having said that, I am very happy not to see so many of these ppl any more. One day, I met a patient at a store and he started yelling and cursing at me and it actually made me happy, because I knew he had probably wented this to someone else as well.

    And if any of those ppl later on could find a reason to sue me for “making them hooked”, they will find some wicked ambulance chaser that is ready to construct a sob story to a jury with a combined IQ that is lower than their shoe size.

    Doctors need to stand up against drug seekers, lawyers and all the other pure SC** out there who make our lives hell every day. My practice has totally turned around after I started being an Ass to these ppl. I will also here mention that I know my OWN patients very well and have no problems giving out anything to the ones that really is ill.

    Finally, the person here that bragged about breaking into some old woman with cancer and stealing her meds, should be given a final pain medicine -> .45 between the eyes, IMHO. World would be better and maybe my patients would not have to wait two weeks to get to see me.

    • Todd says:

      I agree with most of what you say…EXCEPT…labeling someone a drugseeker because they mention a drug by name is from the ice age. Folks all to often look there symptoms up on pc before going to doctor. So it is a normal thing for them to know the name of a drug.

      • Linda says:

        Amen! They advertise drugs to ask your doctor about all of the time. I’m careful about which drugs I take because I’ve had serious reactions, and if I find one I don’t have a serious reaction to, I’m going to ask for it. It is a matter of life and death for me. My life is ruined because a CNP would not give me what I had been taking and gave me Tramadol, which almost killed me. Treat your patients for the individuals they are, not by what they ask for.

    • Adhesionman says:

      I agree, especially younger people. Do you really think you are the only one that can read a medical journal. I have a degree in molecular Biology. I have more of an idea on how a drug works on the body than you do. Doesn’t mean I am a “drug seeker” cause I can name something with the correct nominclature.

      And whats up with this “drug seeker” crap anyway. My feeling is that this is doctor propaganda. People who do drugs will do any drugs they can get their hands on. Doesn’t matter if you give it to them or not. They have a mental issue. Then the other half are “seeking” drugs because YOUR medical community is not trying to help them find the cause of their pain. Of course someone will seek drugs if they know they will work cause they are in PAIN. Just because your tests don’t show anything wrong doesn’t MEAN anything. You know that! Why are you refusing your medical oath in favor DEA propaganda. Sounds like you should be in drug enforcement and not a doctor.

    • elgorrion says:

      Ariel, I had a very similar experience to you at my community health center. I tend to think that I ran a “successful campaign” to weed out all my (former) problematic pain patients. In the process I also created a reputation so others will not come to see me. I know these scumbags communicate to each other outside of clinic. Now I see relatively few of these non-productive/non-members of society. I now actually spend most of my time on patients that actually want to get better (as is possible). And this is soo much more satisfying.

  42. Pitifull says:

    This does not make sense to me at all. I was put on Norco for a diagnosed degenerative arthritis and polymyalgia rhuemitca. I then started to have pain over all my joints. Another blood test was run. My sed rate came back at 95. Of course any doctor who graduated med school should know that means inflammation. I began having severe pain in my big toe I called her and she told me to go to ED or Urgent Care. I chose go to urgent care. The UC doctor ran another blood test and my sed rate was 75. She then diagnosed me with gout. She scripted 20 percocet that I did not ask for and told me to stop taking the Norco while I was taking the Percs. Yes I did fill the script for Percs. She told me to follow up with my Rheumy. I got an emergency appointment the next day. Well when I went with my wife, she turned the follow up into a 40 minute scolding about accepting pain meds from another doctor. I was not on a contract with her. She left the the room then called my PCP and told him what happened. She came back and told me she would not be writing anymore scripts for pain.

    The very next day I got a letter from my PCP of 12 years stating he was no longer my PCP. He stated in his letter he will treat me for 30 days but in bold letter he stated he will not prescribe narcotics. He labeled me a drug seeker. I had to go to he ED (I have been there once in 5 years) because of a virus, I was violent vomiting for 2 days. I was treated for the illness. But because of the timing, they specifically told me they would NOT treat the pain associated with my documented illness.

    This alone has diminished my respect doctors. As a matter of fact I hold doctors to higher standards and I have documented problems and they label me as a drug seeker in less than 2 days? I was a patient of both doctors for 12 years!!!!!!

    Needless to say I am fed up with the US health system. It is pitiful to say the least. Doctors in the US expect to be treated like GOD, but the patient is expected to comply like a slave. I once questioned my Rheumy about Indocin. I read it created heartburn. She told me to tough it out and if I didn’t like it then go to someone else. I decided to be compliant. Of course I also ended up with severe acid reflux for 2 weeks. When I called and told her about it , she said…”you are a big boy, you didn’t have to take it”.

    Now I sit here because no doctor will treat my pain. I had an independent blood test run at my expense. I had no idea how much it would cost but I got a bill for $1325!!! The nurse called me and said my sed rate was still high at 65 and everything was pretty much off the charts.

    I called my Rhuemey and she didn’t seem concerned and pretty much blew me off. So I fired her.

    I thought that pain was supposed to be treated as a disease and not a symptom anymore.

    I sit in agony typing this because I have no doctors at the moment when I had documented issues. I have paid at least half to 3/4 of my salary to my healthcare in the last 9 months only to be labeled as a drug seeker and have no doctor to treat my illness. I am out hard earned money and the Doctors get paid big bucks to make my situation WORSE!

    To all doctors……your are NOT GOD. We are taught from childhood that you go to a doctor when you are hurt or are sick. You are taught to accept advise from a doctor. Doctors get paid GENEROUSLY to fix and COMFORT people if they are is distress.

    What the hell has happened to our health care? I am out thousands of dollars and my doctors are RICH to tell me I am a drug attic and refuse treating me. WTF!!!!!!!!!!!

  43. M says:

    I honestly hope that this “seeker” taught you a lesson to not judge a book by it’s cover. Doc’s on their blogs say that they always assume that the patient is truely in pain until they send up a red flag. I beg to differ. I RARELY go to the ER, but when I do it’s when I have maxed myself out on every pain med I have (tyl, motrin, imitrex ext…) They look at me like I am scum, and I have had docs ask me what I am “really there for” WTF I hadn’t been to that ER for atleast 2 years!!! and no other ER’s! Several years ago, about 7 or so, I went to the ER with a severe migraine and severe upper back pain. They were downright rude to me, they certainly changed their attitudes when they found out I was sicker then they had thought! Viral Meningitis. I won’t even go into the time I had appendicitis…. YOU ARE NOT GOD!! and “Migrainers” as you call us are not always LYING! I realize you do have a lot of people who lie, act, and fake pain to get narcotics. I do realize they use the migraine or fibromyalgia to “score” pain meds.
    I think another thing I have read in blogs (this is to all the ER docs who read this and blog as well) is the appearance of your patients, not everyone who is unbathed, and homeless is a scum sucking addict, and their homeless because of their “crack/cocaine habit” (I have read this time and time again) Some homeless people do get sick! In fact they may get sick more often because they ARE homeless. You know… cold weather and shit like that. YOU ARE NOT GODS!!!!!!

  44. This Sucks says:

    I hope and pray to God that any doctors that read this site please read this comment. If you can’t reply nice then don’t… I had a migraine, not a typical one, it hurt so bad my neck hurt, and was stiff. Why was it still well it could have been anything from sleeping the wrong way to a serious condition. I swear I tried everything imaginable to cure it. I was at a #8. I got the priviledge (sarcasm) to have a doctor with a real shitty attitude. He was rude, and when he asked me what worked I told him, I didn’t say “That stuff that starts with a “D” I spit it out. I told him, “I am in no way asking for it” he stomped out and just said F it and gave it to me and immediatly let me go, with out bothering to ask if it was gone or examine my neck. I was labeled a freaken seeker and I did nothing at all to even make him think I am. WTF am I suppose to do? I will say now I am gonna think ALL docs are a bunch of dicks and die before I seek care from them. SO YES SEEKERS SUCK!

  45. Adhesionman says:

    This is like having a credit score with no recourse.

    What if you had a bad credit score because someone posted false information on your SSN and you had NO recourse to adress it.

    These “databases” need to be changed. You should be able to find out if you are labeled something and have a recourse for address.

  46. DrShrink says:

    As a physician, I can say confidently that at the least 75% of the people that come into my ER and 75% of the patient’s I see on IM service are drug seeking. The people with actual pain will not do the things advised to them in order to control the pain.

    For example, those with low back pain won’t lose weight, exercise, and strengthen their abdominal muscles. Those with shortness of breath/COPD exacerbation won’t quit smoking or take their medications appropriately. Those with abdominal pain won’t stop eating fatty foods and lose weight and stick to a high-fiber, low fat diet. Those with migraines won’t avoid their triggers, sleep too much, and keep taking more and more medications, which lead to rebound headaches. They all believe that narcotics are the answer to their problem and that me, as their physician, is to blame for their lack of pain control when it has NOTHING TO DO WITH THE DOC and everything to do with their personal responsibility, something that these people lack. You may tell yourself that you have something truly wrong with you and that you are the only one who is *special*, but you really need psychotherapy to discuss why you felt unimportant to your parents, not more pain medication.

    I treat addicts. I have no problem with asking if they want help when I see these people ask for opiates repeatedly. But, if you are an addict, you are a liar, too. The two cannot be separated.

    To ‘reform’ healthcare, we need to stop spending money on these leeches of society.

    • elgorrion says:

      Hear hear!

    • Kathy Kooper says:

      For a pain patient staying fit is a double edged sword! I have multiple spine injuries and inoperable painful conditions all documented, but because I clean myself up (it make me feel better) Oh and I ma in better shape than a lot of Doctors and their office staff. They assume that I am not in pain! I should be 250 lbs and out of shape, but I know if I don’t exercise, stretch and eat right my pain will increase! Imagine having my pain ridiculed because, though I am 20 years older than the Nurse, my ass is half as wide!!!!!!

  47. May says:

    I have lupus anticoagulant and crohns and fibromyalgia. I was sent to a ruematologist who put me on percocet and told me to come back in 2 weeks. I got to the desk for appt. but they gave me one for 2 months. The percocet was not working ,Iam in terrible pain so I try to call the doc and they dont return my call, I tried everyday to get him but no answer. I went to my regular doc and said these dont work and gave the med for him to distroy. He sent me to a pain management but the prescription was for methodone it scared so I gave the script to my doc.’ I tried the ruemy again but no answer. I even tried late night call and he didnt respond. Finally I got him. They mailed me a prescription but I didnt fill it. I told him I needed to see him. He finally answered. When I got there I waited a long time. Finally Im called in and a large woman told me that the doc dismissed me. i asked why. She put a paper on the counter and I didnt get to look at it. I old her I wasnt on any drugs and she is wrong. I took the prescription out and she snatched it out of my hand and said THANK YOU FOR giving my prescription back. I told her she is wrong about me. I saw the doc behind her look at me and he went into his room. The lady told me to leave, I was crying trying to understand. She said she will call security. I left not knowing why or not being able to say I didnt take the meds. Later in week I got a 3 dollar invoice for me to pay for them mailing me that prescript she snatched from me. She did not take time for me to ask and tell things that happened. I was dismissed.

  48. May says:

    I am not a drug seeker but got labeled one. I went to er because I get blood clots. I take lovenox shots in my stomach and cyclosporine. My legs hurt so bad but the er doc came in and said I was not a emergency. He wanted me to get detoxed. I said what? He left and didnt come back 2 hrs passed and I called my daughter to pick me up. She helped me walk to he car. I had blood clots in my legs.

    What ever that damn piece of paper says is WRONG. I was judged and jurried by him. I dont know how to get that paper and see whats on it.

    Labeled a drug seeker by that ruemy and now I hate going to er because they read a piece of paper and didnt talk to me about it. They judged me.

    • Linda says:

      You have the right to review your medical records, all of them, by law. They have 30 days from your last visit, and if you can prove they charged you unfairly with drug seeking behavior and you had clots you can charge them with slander or liable. They almost killed a friend of mine for the same reason, and 100,000 later in medical bills, I would have sued, had I been her. It is wrong and they have just gotten plain stupid with it.

      • Linda says:

        I don’t agree with suing anyone, but when doctors totally write you off as a drug seeker when you really are in pain and they almost kill you because they don’t do you the courtesy of trying to find why you are in pain, they should not be in the doctor business. you can have compassion even for an addict. If they are addicted, get them help.

  49. Linda Way says:

    I too have been labeled with drug seeking behavior and I’m mad as all get out. whether a person is a drug seeker or really sick, they still need to be treated with compassion. You have no way of knowing whether a person is a drug seeker or a real patient. You can’t control everything that goes on in the world. People who want drugs will get them, but people like me, that have legitimate complaints are paying for :drug seeking status, with our health and our lives.

    http://theprickofthepen.blogspot.com/2011/10/nightmare-at-doctors-office-im-furious.html

  50. elgorrion says:

    I work in a community health center and I LOATHE pain patients!!! Every now and then I have a patient that actually wants to get better – these are the more educated and motivated patients. You chronic narcotic over users and abusers should learn from them – high dose narcotics are not in your best long term interest! Furthermore, throwing a tantrum in a health care clinic is not appropriate behavior.

    • Jim says:

      Yeah, we know you hate us. That’s why we don’t trust you. You wouldn’t last 20 minutes we the condition I have. Maybe you need another job, like scraping road kill off the road. That would actually be too good for you.

  51. Linda says:

    I was not labeled with drug seeking behavior because I ask for pain medicine, I was told I had drug seeking behavior because I needed something to help me sleep, and I had taken Lunesta several years before for a few months. I have multi-drug allergies or intolerance to many medications and am afraid to try anything new. Turns out it was my thyroid causing me not to sleep, so my over the counter meds work just fine now. However, it does not excuse any stupid person for telling me I had drug seeking behavior because I couldn’t sleep. I was about to lose my job because of a lack of sleep, had had no sleep in days, and was a danger driving down the road. Get real, this crap has gone far enough. One of my friends almost died because she had pain in her legs from blood clots and they told her she had drug seeking behavior.I don’t belive in suing people, but I think when it comes to your life, you have no choice, if that is what will keep you alive. It is also a crime to label someone with an untrue charge. It is called slander, and if they write it, it is liable.

  52. Sue says:

    I just had an ACDF. I’ve found that most medical people don’t know what that is:Anterior Cervival Disketomy Fusion.

    I spent most of last year in excruciating pain from 2 herniated discs. I went to the ER 4 times in a 4 week period because the medications I was prescribed-muscle relaxers and narcotic drugs-did nothing for the pain.

    We have two hospital systems in my city and for some reason I just kept going to this same system even though I had some snotty nurse ask me what I wanted them to do for my pain. I think I was crying each time I went-that’s how bad the pain was. I was even prescribed Neurontin which made me so sick I wound up in the ER from dehydration.

    I finally went to their spine center and even though my spinal cord was compressed to 5 mm at C5-6 from a central herniation and at C4-5 at 6.6 mm-the PA who saw me there says I am not a candidate for surgery and refers me to some pain specialist for Epidural Steroid Injections. Lucky me-I was his patient for about 13 weeks and only had one injection. He did tell me that I was probably going to need surgery and looked disgusted when I told him I hadn’t been to a NS or OS because I have no insurance and they wouldn’t see me.

    Well, November rolls around and after suffering since June with the pain my leg became numb. By then a heating pad had became my best friend since all the pain killers they prescribed did nothing-not even MS Contin. I went to the other hospital system and the ER doc automatically referred me to their on call Neurosurgeon who tells me at the consultation that I had a significant spinal cord compression that needed to be addressed. He said that since the conservative treatments had failed-the drugs, PT and epidural-surgery was my next option. Since I was sick of the pain I said I wanted the surgery.

    I’m not going to lie and say I am 100% better but at least the stabbing neck pain that brought me to the ER is gone. I still have numbness in one of my arms and occasionally I get pain plus I have lost some strength in that arm that might never return. Progressive Myelopathy is no fun.

    My point though is that I was treated like a drug seeker too by the first ER that I visited even though I had no previous history of visits to the ER for pain and had NEVER been prescribed a narcotic from them or anyone else except when I had my surgeries in 2010. Even then I never used them because I had no pain. But pain from a herniated disc is horrible and I spent most of the time in tears from it.

    I find it really offensive that some ER doctors think EVERYONE who comes in to the ER in pain is a drug seeker. Karma is a bitch and one day those same doctors are going to get their payback big time.

  53. Jim says:

    It’s interesting that the dr ends by blaming “drug seekers”. Isn’t that how he started out in the first place? By labeling “people”? At least this dr was going through some sort of soul searching and for that I give him credit. He also confirmed something that I have known for a long time: Drs use pain scales, especially the 1 to 10 scale, against patients. He also confirmed that no matter what we do as people who are in chronic pain… we will have any dispostion (happy, sad, nice, beligerent) against us.

  54. Mary says:

    Ironically,
    I was labelled a drug seeker, adn menatlly ill when I went to the local ER with severe back pain. I was in bed in agony for days before going ER. I was afraid of Opiates in thase days. With the Mental health and Drug addict label it took years to get a diagnosis. I couldn’t work, couldn’t attned College, pretty much my life went down the toilet. I was ridiculed and told I had “female trouble”. I now have permanent nerve damage, Chronic pain, and I am on SS, and Welfare. So I am costing everyone money! I would like to work, but the minimal requirements, like ergonomic work area, and padded Chair are too difficult to get. I am also tired of the invalidation, and ridicule! I can hardly even type, the “stress” and Mental health issue that was actually damage to the cartilage in my neck requiring surgery, damged the nerve in my arm!
    The ER Doc, that called me mentally Ill, Drug Seeker, was recently busted with Cocaine and a Prostitute in the red light district! I put his mugshot on my fridge!
    I had to put my life on hold becasue of the numerous misdiagnosis. It took them 15 years to diagnose my Broken tailbone, mind you Medicare paid for thousands in Imaging, and unnecessary tests.
    I have finally found A kind, empathetic Doctor, I haev been through hell. I am afraid to go to the ER. Toradol makes me puke from years of taking NSAIDS until my liver blew up. One Doctor thought he was being clever and doubled up the toradol, leaving me in the featl position for 3 days, puking my guts out. I was on Oxy, until the reformulation gave me hives, my previous Dr was unconcerned. I had to go cold turkey, or else scratch myself to death! I fired that imbecile. So many of the responses made me realize there are a lot of morons out there and many are Doctors. Why should Doctors be in Drug enforcement? Why don’t they treat Drug addicts? Why do people with Pain have to suffer and become disabled, unable to work, as their condition worsens? Why is there such a lack of Empathy? I used to hate drug addicts, they are annoying, and now I understand that many of them are in some kind of pain, physical or emotional, that should be treated. The “drug War” is a joke! Doctors who lack empathy, should go work in a prison or something! I have met some real imbecile Drs, the ones that think all women should fawn over them, the ones with the attention span of a gnat, the ones who look at a tablet, when you talk to them. I wonder if they are looking at Real Estate or Porn? Whatever it is has nothing to do with my chart, because I have to repeat information that should be on the tablet.
    I once offered to set up a Booth for Doctors at a Convention, to simulate various types of pain! I was going to use car batteries, alligator clips and other devices. I thought it would be “educational” and fun! No Luck!

  55. Mike says:

    I am a Physician Assistant in New Mexico at a major teaching university clinic. The hospital there promotes drug abuse and diversion because it helps there bottom line. More visits is more money. The hospital management wants zero complaints. Less complaints improves reimbursement. 90% of complaints come from drug seekers who don’t get what they want. So hospital management threatens to terminate the PA or NP who gets a complaint. They don’t tell the PA of NP to write more narcotics. They simply tell the PA or NP that if you get more complaints from drug seekers, you’ll be fired. By way of indirection, the message from management is that the PA or NP should write a scrip for narcotic whenever it is demanded by a patient or risk termination. Does anyone wonder why New Mexico has the highest death rate from drug overdose?

  56. killopher says:

    Ironically, being treated like a “drug seeker” by uncaring, god playing, overpaid doctors actually TURNED me into a full blown junkie. Because lets face it, someone in chronic, severe pain will turn to whatever they can to get relief…even *gasp* street drugs. So, thanks all of you for ruining my life. I show up to a doctors office with a REAL problem and am sent away with exercises I can’t do (btw, my joint pain is in NO way caused by being overweight. I’m 5’9″ 165# not overweight in any way shape form or fashion.) And muscle relaxers I can’t take without a 3 day hangover. All because you are ALL overpaid cowards who care more about the “rush” you get from catching a “drug seeker” than providing meaningful relief for people who are truly suffering AND paying your salary. Really guys, if you wanted to bust “dopers” you should have become cops…oh wait, pays too little, too much risk, AND involves REAL work! You are all despicable. The worst kinds of humab beings. I have jury duty in a month and I PRAY that I’m called for a malpractice trial, because I WILL ignore every shred of evidence and vote to convict regardless. Turnabout IS fair play after all…

  57. BethD says:

    I have had a migraine for the last six years. No, this is not impossible. I do have pain free hours, sometimes 5 or 6, but I never have a totally pain free day. I did NOT go directly to narcotics for help. I go to the Jefferson Headache Center, which is one of the top facilities of it’s kind, and they are now at a loss as to how to help me. I have been in pain management, where I am allowed to take pain medications three days a week. This means I have to decide which three days I want to function well. I frequently guess wrong. If I know I have an important event, like my son’s graduation, I will wait to take pain meds so I can actually get through it. I have, unfortunately, a vast sea of experience with being treated like a drug seeker. I have told doctors in the ER, “Look, if you think I am here to score drugs, you are right. I am in PAIN, and I am trying to get pain medicine so I can stop being in PAIN. I don’t need a take home prescription, I have meds at home, but obviously they are not helping which is why I’m here. My ER copay is $200. If I wanted to just get high, I could cop a pretty good amount of drugs off the street for that amount of money, and they would probably last me longer too.” It is so sad that people have to suffer, or PROVE their suffering somehow. Addicts will use no matter what, because addicts are professionals at being resourceful. Stopping the human treatment of pain patients won’t stop addiction. Addiction has been around a long time, and will always be around. A reality check for medical professionals is needed.

  58. concerned says:

    This is horrible, this is what we pay for? How dare you judge patients. Totally offended. I am on predisone since the age of 1, i am now 39. I deal with unbelievable side effects, pain because of a medication you doctors put me on as a baby. Then you have the audacity to have a problem with pain?! Doctors damn near killed me twice because of them assuming. Malpractice lawsuits are what you deserve if this is how you treat the sick!!

  59. Sarahhh says:

    Despite what happened you are a good doctor, you are looking out for those drug seekers that make it so difficult for people who actually have pains eithe long term or short term.

    Let me tell y’all my ER visit, recently found out (10/15/14)I have genetics kidney stones at the age of 19. My last two visit with the ER were astounding ( I think because they were tired of seeing me in there) lol they first looked into my file to see i believe if i was in there for narcotics and looking at my record i had 10 kindney stones from age 14-19. This prompt them to do test but because of so many CT’s ive already had they decided sonogram would be better. well 3 hours passed just sitting down ( the stones also create intense lower back pain) and i wanted to ask if i could get something for the pain but because of being scared under drug seeker, I did not ask i took the pain like a champ! Cried A few times in the bathroom and layed on the floor to ease the pain (ewwy!) Then they finally called my name they told me i had 4 kidney stones in the kidney one was close to the tube but the rest were just hanging out in there luckily the biggest one 1.5cm was not the one emerging but the one out of 5mm was… i told them i had a follow up with my doctor i had been waiting over a month to go for my last kidney stone trip and i told them the symptoms aren’t bad at the moment but they said they will be. The doctor understood, he prescribed me 5mg norco along with ointment from a surgical tear in my belly button from throwing up constantly for the pain. One day after i get the pain, i know this pain and its coming! So yesterday (friday) I go to my primary appointment i tell her what happens and i tell her the 5 mg isnt working because i end up throwing it up immediately after. She cuts me off and tells me there is no way she is prescribing me pain medicine and that they are “just kidney stones” I tell her i understand that i am young but if she just looks at the sonogram she will understand well turns out her staff after realising my ER papers never got em. GREAT! so shes telling me i didn’t realise em im telling her i did to look it up then i offer her my ER papers and she says it irrelevant she doesn’t even know if i do have kidney stones?!by this time im upset her story keeps jumping back and forth i asked for a urology referral then she tells me she will prescribe me norcos just for one month and i told her i dont need it for one month i need it just for a week max until the other stones start coming then she switches and says that even if i prescribed u these u wouldnt get them ur healthcare wont cover it and u cant get it out and if u pay for it u will be cut of healthcare. Son she new i needed them, threw my blood work paper at me then stormed out so im sitting there confused, and then she comes back in and tells me that she has nothing more to say to me and she isn’t gonna negotiate with me. Short story. I got upset and stormed out and when i got up she laughed in my face. I asked when i can get my urology referral she laughed again and told me “You don’t think you’re going today, because u have to wait 7 business days” i proceeded to tell her her attitude towards me who have pictures, who have evidence on poor health is extremely rude. ” and this DOCTOR laughed and said whatever.

    Safe to say i need a new doctor and that, my friend is a bad Doctor.

  60. JenC says:

    This site is one of hundreds I’ve read concerning the horrors of so-called “Excellent Medical Care in America ” What a bad joke. What I learned reading thru this is to NEVER EVER go to an ER, even with a broken bone sticking thru skin, (I will have done it to myself?) hemorraging, stroke, heart attack, you name it, I have “willed” myself to have a stroke, etc to “get drugs?” No thanks! I’ll let “whatever” kill me, it’ll save me money, as it appears I would more likely than not to be immediately labeled “addict” than that ER looking for why my face is sagging on one side(I suppose I can make that happen too!) so why bother going? I see new ads nearly daily for frivolous drugs, such as one I saw to stop one from peeing so they wouldn’t be “inconvenienced” at the mall, but nothing in the way of pain killers that actually work that aren’t narcotic! Nothing! What I’ve found is EVERYONE’S a drug addict, that’s all Drs/nurses can see, so why bother with an ER or even an office visit, when no health care is going to occur? Labeling people as “addicts” is now more important than someone with terminal cancer! And if your PCP dies or retires, congrats, you are now a drug seeker or doctor shopping for trying to find a new PCP! I wonder if Ebola victim, Mr Duncan, was booted from the ER for saying his stomach “hurt,” potentially unleashing Ebola all over the place? Thankfully it didn’t, but look at all the contact tracing, etc that could’ve been avoided if they would’ve heard the two times! hospital ER was told he was just in West Africa, but only heard the word “hurt” & boom! Drug Addict is ALL they could see! Wait for enough ppl to die, who have their “suicide letter” tucked away, (there’s a LOT of them, I found over 50 in 1 day of reading “health forums”-how many more who don’t post?) explaining why they did it, not from depression, but from total lack of healthcare & could no longer stand the misery of whatever illness they had & are making sure their death isn’t written up as some bogus “heart failure”- can you spell huge class action suit? It’s coming & all because those 1-2% of population addicts is all the medical “profession” is concerned with. OK!

  61. BD MD says:

    Yes, we have to judge patients…

    It’s years of knowing when someone is sick…when pain is real…or amplified…It’s how you learn to tell when something is really wrong…

    We do this with everything…not just pain…

    And I hate to say most of us were educated in all of the above in the most painful way.

    Being played and burned in the most humiliating ways…

    Having to justify what we did to higher ups when we clearly did not see the red flags…and the evidence behind them…

    Fool me once…

    Can’t you tell when you are being manipulated into something by your kids?

    What we are talking about here isn’t even usually that hard to figure out…

    I have to trust my instinct and what you tell me and how you tell me and whether it is internally consistent and physiologic guides me.

    If I deflect a hair on your skin and you cringe in pain???

    Sorry…

    Nearly every single time my instinct said not to…and I did give that narcotic refill…it came back to disappoint me…

    We aren’t gods…we are sometimes wrong about things…we learn from them…

    We learn from everyone who was real And suffering and dying and we learn from being played and made a fool of…
    Is it really that a sequence of grossly malpracticing docs were in your life path? Sounds kind of too bad to be true…

    Fool me twice :)

    But not so after so many years…I happen usually to be right in these matters…Not out of arrogance…But because this is what I know…what I have given my life over to be the best at…

    So I won’t be fooled twice :)

    But I won’t be wrong twice either…!

  62. Talina says:

    I’m a recovering opiate addict. I had been for 7 years. 2 years ago I “switched” to methadone. But you know, if it walks and quacks like a duck…it’s still a duck. Im today 68 days clean of everything by white knuckle method. I’m not really replying to tell my story. I just wanted to say I’m sorry. I sought out my drug and I lied and manipulated to get it. I can’t tell you how ashamed that makes me. If I had any advice to give it would be to start a dialogue with your patient. Just tell them your concerns, share the dangers of addiction and offer help if they feel like they could use it. Not all will admit a problem or accept help, but some will. It only takes one spark to start an fire.

    • BD MD says:

      Good luck…
      It requires your desire and strength one white knuckle day at a time…I hope you have a lot of people around to help you….

  63. Talina says:

    Thank you!
    I’m well supported by my family and NA group. I think most addicts have a desire to be clean and free of their addiction… It’s just difficult to believe it’s possible. It took me a few years, but I’ve set my sights on waking up every morning and not needing a drug to function. And that is exactly what I’ll do.

    • BD MD says:

      Lost my husband to alcohol at 44.
      Even 3 young beautiful children weren’t enough.
      Addiction destroys not only the victim…
      But the whole family unit…
      My boys have suffered as they grew up,..

      Be a success story with and for your family!!

  64. Christie says:

    You have NO business being in the medical profession. And to go as far as to say “Drug Seekers Suck!?” You disgust me. Apparently you’ve never experienced pain, nor had long term prescriptions fo4 painful medical conditions. Your empathy and professionalism seems WAY beyond sadly lacking. I’m sure McDonalds is hiring. Be a fry cook. Little to no professionalism required. Oh and BTW- YOU suck!

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