What’s the quickest way for a pain patient to be labeled a drug seeker?
Ask for a drug!
That’s no joke. Drug diversion experts say red flags go up when a new patient walks into a doctor’s office and asks for a particular type of painkiller.
“It may be that the medication prescribed by another physician was very helpful to them. but walking in that door asking for a specific drug, my radar would be up,” says Charlie Cichon, executive director of the National Association of Drug Diversion Investigators, a non-profit that educates health care providers about drug abuse and diversion.
“Some physicians like to prescribe a certain oxycodone or hydrocodone pill. That’s what they’ve seen that helps most of their patients.”
So when a new patient asks for something else, Cichon says a doctor may quickly grow suspicious that a patient is a potential drug abuser or dealer.
“A patient who comes in saying, ‘You know maybe I shouldn’t have done this, but I tried this pill that my cousin had and it really did help me. I was able to drive my car, I was able to pickup my kid, or I was able to go to work.’ That would really, I think, set off some kind of alarm.”
Cichon and his colleague John Burke recently completed a series of seminars at PAINWeek, a national health conference in Las Vegas for practitioners in pain management. Their lectures on topics like “Protecting Your Medical Practice” and “Drug Diversion and Pain Management” were standing room only — the room filled with hundreds of doctors worried about becoming unwitting casualties in the War on Drugs.
“The physicians really don’t want a visit from law enforcement or the regulatory board. Everybody’s looking at different monitoring systems and counting pills. How many is the doctor prescribing? How many is the pharmacist filling?” Cichon told National Pain Report.
“Unfortunately, its possibly harming the legitimate patient that’s out there, who is trying to get legitimate pain medication and trying to fill it too.”
Cichon and Burke say actual drug seekers use a whole range of techniques to woo or scam physicians into prescribing pain medicine; such as complimenting the doctor, deliberately mispronouncing a drug’s name, threatening to sue, or becoming agitated when a doctor prescribes something besides their drug of choice.
“If you’re in a pain management practice, and even if you’re not, you’re going to get duped from time to time,” said Burke, who is President of the National Association of Drug Diversion Investigators.
Burke advises doctors to get new patients to fill out detailed history forms listing the drugs they’ve taken and the practitioners they’ve seen. Patient names should also be run through prescription drug monitoring systems. If one isn’t available, he suggests calling the patient’s old doctors or even local emergency room physicians to verify the information they’re given.
“You might learn a lot about your patient that you didn’t know. What goes on at 3 o’clock in the morning in the emergency room may be a lot different in your office at 3 o’clock in the afternoon.,” Burke said.
Even the patient’s behavior in the waiting room can be a telling sign. Burke says doctors should listen to their office staff, because they are often the first to recognize a drug seeker — who may act nervous or impatient while waiting to see the doctor.
“You really have to know your patient, especially if you believe that patient is going to be coming on a regular basis and you’re going to be prescribing these drugs that are abused,” says Cichon.