Do you hate the term “drug seeking” when it’s used on people who are seeking legitimate medication?

[Anonymous]

Anonymous wrote:Addiction is still very poorly understood by ER health care professionals. Most don't seem to have any understanding of why an addict would be 'drug-seeking'. They just see this as a person lying, being attention seeking, manipulative, and overall a bad person.

Also the idea of anyone who knows their own health being seen as a threat to the expertise of the docs/nurses and therefore gets dismissed and treated poorly because how dare anyone say they know what works for them...

You can know what works for you. You can say you know what works for you. You cannot force a licensed professional to put that license on the line to do what you say, just because youa re saying it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Addiction is still very poorly understood by ER health care professionals. Most don't seem to have any understanding of why an addict would be 'drug-seeking'. They just see this as a person lying, being attention seeking, manipulative, and overall a bad person.

Also the idea of anyone who knows their own health being seen as a threat to the expertise of the docs/nurses and therefore gets dismissed and treated poorly because how dare anyone say they know what works for them...

You can know what works for you. You can say you know what works for you. You cannot force a licensed professional to put that license on the line to do what you say, just because youa re saying it.

True, but it is cruel for that “professional” to react by telling others you are drug-seeking and either discharge you without care or ignore you in a room for hours.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Addiction is still very poorly understood by ER health care professionals. Most don't seem to have any understanding of why an addict would be 'drug-seeking'. They just see this as a person lying, being attention seeking, manipulative, and overall a bad person.

Also the idea of anyone who knows their own health being seen as a threat to the expertise of the docs/nurses and therefore gets dismissed and treated poorly because how dare anyone say they know what works for them...

You can know what works for you. You can say you know what works for you. You cannot force a licensed professional to put that license on the line to do what you say, just because youa re saying it.

True, but it is cruel for that “professional” to react by telling others you are drug-seeking and either discharge you without care or ignore you in a room for hours.

I don't think that any patient ever deserves cruelty, or being ignored, or being disrespected. Professionals should be professionals. Language should be thoughtful, precise, and accurate -- and kind, as much as possible.

That being said, there is no words you can use to explain to a patient that you are not going to prescribe what they think they need (but which it is in your medical judgment, and on your license, inappropriate) that goes over well. It can be done better or worse ways, but it is never welcomed.

An emergency room is required to stabilize people. It is not there for longterm management. If you are discharged and stable, they have done their job.

And I say this gently and sincerely -- often a big part of emergency room care is observation. Someone comes in with serious distress, and the examination, including vitals, is non-worrisome. You watch and wait to see if something worse develops. Ideally this is communicated to the patient -- sometimes it is, sometimes it isn't, and sometimes it is but the patient doesn't hear it. And sometimes a multi-car pile-up comes in and it's all hands on deck elsewhere.

I hope you find a plan to move forward that works better than what has happened in the past. I'm sorry you are dealing with this on top of pain.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have an NSAID/aspirin allergy so that will get you flagged as a drug seeker even though I've never been prescribed painkillers for any condition so not for migraines or for any major dental work, abscesses, never. I had a sinus lift dental surgery for an implant which will cause swelling. I was prescribed nothing at all because the minute you say allergy they flag you. My husband and neighbour had the same surgery and were prescribed a short course of painkillers so along with the NSAIDS they could live comfortable through the post operative period. I just had to tough it out. Apparently the drug addicts all say they have the allergy which then reflects on people who really do.

Interesting. I have the same allergy and have never been flagged. And I’ve had several inpatient and out patient surgeries. Your doctors should be prescribing steroids for swelling/pain. And there are other drugs than NSAIDS for migraines.

My neurologist wants me to use them as a break from Imitrex as I take it daily so when it gets bad, because she gives me the max amount she can I have to limit what I take so in theory I need something stronger (which I've never done). You cannot or should not take two different triptans in 24 hours to make sure the first is out of your system. My migraines are so bad, I don't need anything for dental work, including for cavities. The 2 minutes of drilling is no big deal compared to my migranes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have an NSAID/aspirin allergy so that will get you flagged as a drug seeker even though I've never been prescribed painkillers for any condition so not for migraines or for any major dental work, abscesses, never. I had a sinus lift dental surgery for an implant which will cause swelling. I was prescribed nothing at all because the minute you say allergy they flag you. My husband and neighbour had the same surgery and were prescribed a short course of painkillers so along with the NSAIDS they could live comfortable through the post operative period. I just had to tough it out. Apparently the drug addicts all say they have the allergy which then reflects on people who really do.

Interesting. I have the same allergy and have never been flagged. And I’ve had several inpatient and out patient surgeries. Your doctors should be prescribing steroids for swelling/pain. And there are other drugs than NSAIDS for migraines.

My neurologist wants me to use them as a break from Imitrex as I take it daily so when it gets bad, because she gives me the max amount she can I have to limit what I take so in theory I need something stronger (which I've never done). You cannot or should not take two different triptans in 24 hours to make sure the first is out of your system. My migraines are so bad, I don't need anything for dental work, including for cavities. The 2 minutes of drilling is no big deal compared to my migranes.

What does the above have to do with being flagged as drug seeking when you have an NSAID allergy?

[Anonymous]

I’ve started carrying my medical files with me on my phone for this purpose. Saves time with judgemental medical folks and expensive tests.

Just give me the pain meds.

[Anonymous]

Anonymous wrote:

Anonymous wrote:As a former ER nurse, I've seen this label thrown around a lot.

We get frequent fliers who are there to abuse meds for sure. And not just controlled substances but we've had quite a few who like the attention of the ED.

I'd say the number one reason people get this label thrown at them is when they come to the ED and tell the staff what they need before all tests have been performed. I'm guessing that's what happened with the IV PP. Now there are some people with chronic issues who know what works for them. Im not denying that. But if a staff member doesn't know you and you come in and tell them that last time this happened the only thing that works is Dilaudid, Ativan, and Phenergan....a red flag is going to be raised.

The worst thing about the current opiod crisis is that it penalizes those with legitimate flare ups or need for pain management. I have seen some crazy drug seeking behavior from people who wanted medication, not needed it. After awhile you can't help but become jaded to it all.

Why is Phenergan a red flag medication?

NP. my understanding is phenergan is only a addictive when it is combined with codeine.

[Anonymous]

Anonymous wrote:I’ve started carrying my medical files with me on my phone for this purpose. Saves time with judgemental medical folks and expensive tests.

Just give me the pain meds.

Yes, I love the app that most providers use. It has easier the way somewhat,

I understand that medical professionals get suspicious when they hear laymen use terms that they struggled to learn in nursing or med school. All I can say is that I was forced to educate myself about my condition and what works best for my body or has no positive effect at all. I don’t pretend to know about how anyone else should be treated, but if I don’t advocate for myself I know I will suffer needlessly, especially in a bust ER.

That said, Holy Cross Hospital is my go to now. They know me and my doctor so I can usually keep the conversation short and simple. I also take a friend or family member with me if possible. No one looks their best when drenched with cold sweat from nausea or pain. I guess that gets mistaken for junkie. Take a well dressed and articulate advocate if possible.

[Anonymous]

Remember, too, that there was a big push in the 80s and 90s that "pain is an emergency" and that pain was being undertreated & not taken seriously. This wasn't just a "big pharma" push -- it was patient advocacy. And so more pain meds were prescribed, by at least an order of magnitude.

And now there is pushback because of an opiod addiction crisis. Nobody wants a person to suffer in pain, but physicians remember where "listen to your patients" advocacy went too far before. There has to be a better balance point found, but I think the pushback is real.

[Anonymous]

Anonymous wrote:I’ve started carrying my medical files with me on my phone for this purpose. Saves time with judgemental medical folks and expensive tests.

Just give me the pain meds.

Our ER has full access to our medical and pharmacy records, which is nice but it doesn't really help as usually they don't take the time to read them.

[Anonymous]

Happened to me recently, I had an accident with internal injury and internal bleeding, the pain was through the roof, they did not believe me, chastised me and conveniently "forgot" me in a waiting cubicle. Once CT scan showed internal bleeding, the er doc apologized but it did not take away from the crazy pain or being essentially abandoned while I as pleading for help. Oh well. I guess its the reality these days.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Addiction is still very poorly understood by ER health care professionals. Most don't seem to have any understanding of why an addict would be 'drug-seeking'. They just see this as a person lying, being attention seeking, manipulative, and overall a bad person.

Also the idea of anyone who knows their own health being seen as a threat to the expertise of the docs/nurses and therefore gets dismissed and treated poorly because how dare anyone say they know what works for them...

You can know what works for you. You can say you know what works for you. You cannot force a licensed professional to put that license on the line to do what you say, just because youa re saying it.

True, but it is cruel for that “professional” to react by telling others you are drug-seeking and either discharge you without care or ignore you in a room for hours.

I don't think that any patient ever deserves cruelty, or being ignored, or being disrespected. Professionals should be professionals. Language should be thoughtful, precise, and accurate -- and kind, as much as possible.

That being said, there is no words you can use to explain to a patient that you are not going to prescribe what they think they need (but which it is in your medical judgment, and on your license, inappropriate) that goes over well. It can be done better or worse ways, but it is never welcomed.

An emergency room is required to stabilize people. It is not there for longterm management. If you are discharged and stable, they have done their job.

And I say this gently and sincerely -- often a big part of emergency room care is observation. Someone comes in with serious distress, and the examination, including vitals, is non-worrisome. You watch and wait to see if something worse develops. Ideally this is communicated to the patient -- sometimes it is, sometimes it isn't, and sometimes it is but the patient doesn't hear it. And sometimes a multi-car pile-up comes in and it's all hands on deck elsewhere.

I hope you find a plan to move forward that works better than what has happened in the past. I'm sorry you are dealing with this on top of pain.

The problem is that the health professional often is poorly informed when they make this call. They make all kinds of assumptions, don't listen to the patient or ask questions to find out what is really happening, and have the wrong idea of the situation. So they often think something is inappropriate because they don't have (nor want) the information that would provide the context for the request. It is easier and faster to just jump to a quick conclusion and prescribe something really easy, general, and safe where you don't even need to know the story. Very few doctors have any interest in outcomes or whether or not their treatment was effective or worked. They just want to move down the line and erase you off the board and get you out the door alive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Addiction is still very poorly understood by ER health care professionals. Most don't seem to have any understanding of why an addict would be 'drug-seeking'. They just see this as a person lying, being attention seeking, manipulative, and overall a bad person.

Also the idea of anyone who knows their own health being seen as a threat to the expertise of the docs/nurses and therefore gets dismissed and treated poorly because how dare anyone say they know what works for them...

You can know what works for you. You can say you know what works for you. You cannot force a licensed professional to put that license on the line to do what you say, just because youa re saying it.

True, but it is cruel for that “professional” to react by telling others you are drug-seeking and either discharge you without care or ignore you in a room for hours.

I don't think that any patient ever deserves cruelty, or being ignored, or being disrespected. Professionals should be professionals. Language should be thoughtful, precise, and accurate -- and kind, as much as possible.

That being said, there is no words you can use to explain to a patient that you are not going to prescribe what they think they need (but which it is in your medical judgment, and on your license, inappropriate) that goes over well. It can be done better or worse ways, but it is never welcomed.

An emergency room is required to stabilize people. It is not there for longterm management. If you are discharged and stable, they have done their job.

And I say this gently and sincerely -- often a big part of emergency room care is observation. Someone comes in with serious distress, and the examination, including vitals, is non-worrisome. You watch and wait to see if something worse develops. Ideally this is communicated to the patient -- sometimes it is, sometimes it isn't, and sometimes it is but the patient doesn't hear it. And sometimes a multi-car pile-up comes in and it's all hands on deck elsewhere.

I hope you find a plan to move forward that works better than what has happened in the past. I'm sorry you are dealing with this on top of pain.

The problem is that the health professional often is poorly informed when they make this call. They make all kinds of assumptions, don't listen to the patient or ask questions to find out what is really happening, and have the wrong idea of the situation. So they often think something is inappropriate because they don't have (nor want) the information that would provide the context for the request. It is easier and faster to just jump to a quick conclusion and prescribe something really easy, general, and safe where you don't even need to know the story. Very few doctors have any interest in outcomes or whether or not their treatment was effective or worked. They just want to move down the line and erase you off the board and get you out the door alive.

The quickest way to get rid of you is just to give you a prescription for what you want. Apparently, that's not happening.

[Anonymous]

PS: Also, ERs are supposed to stabilize. They are not designed or suited for longterm management -- they are supposed to keep you alive for the immediate foreseeable future.

If you need longterm management, you need an ongoing relationship with a primary care physician. If you've had multiple PCP relationships come to an end, then there is probably a pattern.

[Anonymous]

There are plenty of medical terms that are outdated and disrespectful, because they established themselves in an age where people where judged in that way in all aspects of their lives.

"Advanced Maternal Age". "Incompetent cervix". The concepts of failure and insufficiency in medical language are sometimes extremely judgemental, particularly as they pertain to women. Of course.