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> Informational Brochures > Don't Be Scammed By A
Drug Abuser
December 1999
Vol. 1, Issue 1
Inside this Issue:
The purpose of this guide is to inform
and educate you, the healthcare practitioner, to ensure that controlled
substances continue to be available for legitimate medical and scientific
purposes while preventing their diversion into the illicit market. It is not
the intent of this publication to reduce or deny the use of controlled
substances where medically indicated. Nothing in this guide should be
construed as authorizing or permitting any person to conduct any act that
is not authorized or permitted under Federal or state laws.
Your
Responsibilities
The abuse of prescription drugs--
especially controlled substances--is a serious social and health problem
in the United States today. As a healthcare professional, you share
responsibility for solving the prescription drug abuse and diversion
problem.
-
You have a legal and ethical
responsibility to uphold the law and to help protect society from drug
abuse.
- You have a professional responsibility to
prescribe controlled substances appropriately, guarding against abuse
while ensuring that your patients have medication available when they
need it.
-
You have a personal responsibility
to protect your practice from becoming an easy target for drug
diversion. You must become aware of the potential situations where
drug diversion can occur and safe- guards that can be enacted to
prevent this diversion.
This guide will help you meet these
responsibilities.
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Recognizing
the Drug Abuser
Telling the difference between a
legitimate patient and a drug abuser isn't easy. The drug-seeking
individual may be unfamiliar to you. They could be a person who claims to
be from out-of-town and has lost or forgotten a prescription of
medication. Or the drug seeker may actually be familiar to you such as
another practitioner, co-worker, friend or relative. Drug abusers or
"doctor-shoppers" often possess similar traits and modus
operandi. Recognizing these characteristics and modus operandi is the
first step to identifying the drug-seeking patient who may be attempting
to manipulate you in order to obtain desired medications.
Common Characteristics of the
Drug Abuser:
-
Unusual behavior in the waiting
room;
-
Assertive personality, often
demanding immediate action;
-
Unusual appearance - extremes of
either slovenliness or being over-dressed;
-
May show unusual knowledge of
controlled substances and/or gives medical history with textbook
symptoms OR gives evasive or vague answers to questions
regarding medical history;
-
Reluctant or unwilling to provide
reference information. Usually has no regular doctor and often no
health insurance;
-
Will often request a specific
controlled drug and is reluctant to try a different drug;
-
Generally has no interest in
diagnosis - fails to keep appointments for further diagnostic tests or
refuses to see another practitioner for consultation;
-
May exaggerate medical problems
and/or simulate symptoms;
-
May exhibit mood disturbances,
suicidal thoughts, lack of impulse control, thought disorders, and/or
sexual dysfunction;
-
Cutaneous signs of drug abuse -
skin tracks and related scars on the neck, axilla, forearm, wrist,
foot and ankle. Such marks are usually multiple, hyper-pigmented and
linear. New lesions may be inflamed. Shows signs of "pop"
scars from subcutaneous injections.
Modus Operandi Often Used by
the Drug-Seeking Patient Include:
- Must be
seen right away;
- Wants an
appointment toward end of office hours;
- Calls or
comes in after regular hours;
- States
he/she's traveling through town, visiting friends or relatives (not a
permanent resident);
- Feigns
physical problems, such as abdominal or back pain, kidney stone, or
migraine headache in an effort to obtain narcotic drugs;
- Feigns
psychological problems, such as anxiety, insomnia, fatigue or
depression in an effort to obtain stimulants or depressants;
- States that
specific non-narcotic analgesics do not work or that he/she is
allergic to them;
- Contends to
be a patient of a practitioner who is currently unavailable or will
not give the name of a primary or reference physician;
- States that
a prescription has been lost or stolen and needs replacing;
- Deceives
the practitioner, such as by requesting refills more often than
originally prescribed;
- Pressures
the practitioner by eliciting sympathy or guilt or by direct threats;
- Utilizes
a child or an elderly person when seeking methylphenidate or pain
medication.
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What
You Should Do When Confronted by a Suspected Drug Abuser
DO:
-
perform a thorough examination
appropriate to the condition.
-
document examination results and
questions you asked the patient.
-
request picture I.D., or other I.D.
and Social Security number. Photocopy these documents and include in
the patient's record.
-
call a previous practitioner,
pharmacist or hospital to confirm patient's story.
-
confirm a telephone number, if
provided by the patient.
-
confirm the current address at each
visit.
-
write prescriptions for limited
quantities.
DON'T:
-
"take their word for it"
when you are suspicious.
-
dispense drugs just to get rid of
drug-seeking patients.
-
prescribe, dispense or administer
controlled substances outside the scope of your professional practice
or in the absence of a formal practitioner-patient relationship.
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