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Desperate Drug Seeker

The desperate drug seeker can be divided into two separate categories; those who seek drugs for their own use and those who seek drugs for other reasons.

Desperate Drug Seeker – Seeks Drugs for Own Use – Reasons (Mindset)

  • Patient beginning to have a problem with their medication (displays aberrant behavior – voiding withdrawal);
  • Addicted to prescription medication; or
  • Addicted to narcotics in general.

Gaining the prescription can be the most important issue on this patient’s mind at the time the patient is in the examining room.

The Desperate Drug Seeker – Seeking Drugs for Other Reasons – Reasons (Mindset)

  • The patient gains prescription pain medication under duress (normally female).
    • Based on the threat of assault; or
    • Based on the threat of abandonment (her or her and child).
  • Gain prescription medication to sell (many on fixed income).
    • To gain money for food;
    • To pay their bills; or
    • To provide money to help family members.

Note: These drug seekers are not as desperate as those who seek drugs for their own use, but they are desperate nonetheless.

The vast majority of desperate drug seekers are those who seek drugs for their own use. A very small minority of desperate drug seekers attempt to obtain drugs for other reasons.

Methods

They will rely heavily on:

  • Past Experiences; and/or
  • What they have been told.

Clinic Selection

They will select clinic based on:

  • Pure chance; or
  • What patients say about the clinic.

Flags

The patient may:

  • Ask for specific Rx medication;
    • May request specific strength.
  • Run out of medication early (display aberrant behavior);
  • May exaggerate symptoms; and/or
  • May make excuses as to why they cannot participate in the complete treatment program:
    • Exercise
    • Weight Loss
    • Physical Therapy
  • May make excuses as to why they cannot participate in patient accountability practices:
    • Pill Counts; and/or
    • Urine Drug Tests.
  • Request change of medication:
    • Because they are running low or have taken all of their current prescription;
    • Hoping to keep left over medication; or
    • Hoping to get the medication they really want.
  • Disagree strongly when faced with changing their medication.
  • Subconscious verbal and non-verbal cues may present when you ask the patient significant questions.

Note: A significant question is any question, which based on the patient’s response, would cause you to change, refill of discontinue the patient’s medication.

Safeguards

  1. Maintain an updated patient agreement.
  2. Enforce your patient agreement.
  3. Observe (and understand) the patient’s body language.
  4. Conduct urine drug tests and pill counts. Note: rely on lab conformations for urine drug testing. Presumptive tests can provide false negative or false positive results.
  5. Promote an open rapport with your patients.
  6. Utilize Rx Monitoring Program if provided by your state.

Established Patients

They will select clinic based on:

  • Keep an open relationship with your patients.
  • Keep a good balance between stating your intention to enforce your opioid agreement and encourage your patients to identify problems they may be experiencing.

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