Tips for drug seekers...

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Now that that is established....whew!



I truly am amazed at some of the "lines" that are heard within the walls of a clinic/hospital sometimes.  In my job, and in my student career, I am really hearing some doozies.  While I understand that drug addictions are a very hard thing to deal with, and while I understand that it's the drug and not the person putting up such a desperate plea for more drugs, we have a job in the medical profession.  That job is to provide safe care to our patients...and to protect others.  There is no way that giving you 30 tablets of narcotics when you are clearly burned out on several drugs already is a safe thing...for the patient OR for the people sharing a road with that person.


So here is a bit of advice of what NOT to say when coming in to the clinic, or calling, for additional pain medications that aren't warranted.  (Yes.  True stories!)

1.  "I called and spoke to Nurse A yesterday, who said that getting an early refill would not be a problem.  Do you happen to know the status of that request?"

This is usually a red flag.  Number one---early refills aren't handed out freely.  Number two--we do have  a  very accurate means of documentation.  I can see clearly from said documentation that Nurse A told you very firmly that NO, you may NOT have an early refill of your Oxycodone.  Suggesting that Nurse A "misunderstood" your previous request will not get you anywhere. Suggesting that Nurse A was incapable of understanding the nature of your request will not get you anywhere but to the bottom of the priority list, as you just insulted her.

2.  Do no call and say that your best friend was visiting you, and while you were in the bathroom, your best friend apparently found your pill bottle and stole it.  And, oh yeah!  We have it documented that your best friend also stole your pills 2 months ago.  Get a new best friend.

3.  Do not call and say that you "accidentally threw away" your signed hard-copy prescription of your narcotic that was just given to you.  You are a "frequent flyer" as we say, and we know you much much better than that.  You would never misplace such a beloved document.  And, oh yeah!!  I can see in your chart that you also accidentally threw your prescription away 3 months ago.  Get a new excuse.

4.  Do not tell me your dog ate your pills.  Your dog would be dead if it did.  Didn't you know that excuse ran lame back in junior high?

5.  Do not call to say that you were involved in an automobile accident, and unfortunately, all of your narcotics were in the vehicle with you and got lost in the accident.  I am pretty sure that if you were in a serious accident that you are getting medical care somewhere, and they are most certainly treating your pain.  But, giving you the benefit of the doubt, we will ask you to have a police report sent just to verify this accident really happened.  That way, if your stories match, you can get some new pills.  Guess what?  When toxicology screening is done in the ER after the car accident, we do receive the outside medical records.  Having ZERO trace of the narcotic we are prescribing you in your system, and a very high level of a narcotic we are NOT prescribing you show up in your lab work is not a good thing.  So what have you been doing with your monthly refills of narcotics if they aren't being taken by you?  Selling, much?  (Rumor is that some of the narcs go for $30 per tablet on the black market!)

6.  Do not EVER call and say that your young child got ahold of your Valium and flushed it down the toilet.  Not only will it not get you a new prescription, but it will likely get you reported to CPS.  Little kids and narcotics do not mix.

7.  Do not call and tell us that your pain is a 15/10 and you will show up in the lobby to pick up your signed prescription as soon as we can get it ready.  If your pain really were a 15/10, I promise you wouldn't be talking, walking, driving, or functioning.  You would be curled up in bed, screaming in pain, sweating, trembling, and unable to function.  I had one patient in my career so far who said their pain was a 15/10 that I have believed.  This patient's brain was herniating,  though there was no way we could have known that at the moment.  Brain herniation is something we learn either on CT scan or autopsy. It's not compatible with life.  I still grow sick to my stomach when I relive that experience.  That pain was rated a 15/10.  There is no way your pain is a 15/10 if you are readily agreeing to drive yourself to the office.

8.  Do not call and say that you think someone was "imposing" when they came to pick up your narcotic prescription from the office.  How would the said "imposter" know when we told you to come and pick it up?  Take off your imposter disguise and confess---it was you who picked it up earlier---and now you are trying to get another prescription while posing as "yourself".  Guess what, we also use several patient identifiers before handing signed narcotic Rx's over, and the "imposter" breezed by those without problems. And, oh yeah!  It was documented last month that an "imposter" came as well.  Get a new excuse.  We know you too well.

9.  Do not let yourself get angry when you are told "no".  There is no good in raising your voice, calling names, or becoming irate.  We are trained to recognize drug-seeking behaviors, and part of that includes flying off the handle when things aren't going your way.  You just fell into every textbook description. Thank-you for making it easy.

10.  Do not suggest that you "threw away" your narcotics because you were doing "so well" that you thought you didn't need them anymore.  Now, you are calling a day after "throwing them away" because your pain is so uncontrolled.  Funny how you suddenly were "healed" when not even one week prior, you called begging for an early refill.  Yes, remember our documentation? Just tell me that you sold that bottle of pills and are now trying to locate another one.

You know, some doctors have a policy that they never prescribe narcotic pain medications.  After being exposed to some of the headache that goes into safely prescribing narcotics, I am thinking it might be a practice I consider in my future career!  I can recognize when someone truly is in need of narcotics and when someone is becoming addicted.  Again, while I understand addiction, it is our job as providers to keep you and others safe.  We really just cannot keep feeding your addiction by overprescribing for you.  Period.