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Addiction and Substance Abuse

Daughter who cares!!!!

08/06/2003

Question:

How do you know if a person is abusing prescription pain medication, and not just truely in pain? If the person in question is abusing, is it possible for them to go to an er at the local hosp. to get either a new prescription or a totally new type of narcotic pain medication without the physician realizing that the patient is abusing???

Answer:

Hello,

This is a question that not only patients and families have difficulty with, but also health care providers. There are patients who have severe non-cancer pain that devastates their life and hurts those around them. These patients need effective pain relief. This can sometimes be done in different ways such as physical therapy, antidepressants (low doses do help treat pain), massage, acupuncture, braces, exercises, etc.

However, there are times when everything else fails or doesn`t help enough and the patient requires opiate medication. There are recommendations in many states that instruct a doctor how chronic opiate pain meds can be prescribed legally. In Ohio, where I practice, there are requirements to follow in doing this that insure patients receive proper evaluation before starting on pain meds for chronic pain. A physician who disobeys these regulations can have action taken against their Medical License by the State Medical Board.

Assuming someone is appropriate to receive opiate pain meds, they need to sign a contract with their doctor that states they will get their medicine from only 1 doctor and 1 pharmacy. If patients choose otherwise, they have broken their contract and the doctor may refuse to prescribe further pain pills. If a patient sees a couple or several different doctors for pain and each one is prescribing for that patient and is not aware of the other doctors who are also prescribing, the patient may be charged with a felony criminally because they are lying to obtain controlled substances. It is always best to be totally honest with the doctor in charge and not try to go around behind their back. Again, this is very risky for the patient in many different ways.

ER doctors are wise to patients who come in with stories to try to get opiates and may call their doctor before prescribing any pain meds at release to verify the patient`s story and provide continuity of medical care for the patient. There are patients who go "doctor shopping" and try to get drugs from many doctors; however, this is illegal.

Patients with drug abuse or addiction problems will take control of their own medications and make up reasons why they need more medications and increase their dosage on their own without discussing things with their doctor. If patients sneak around to get drugs, they have an abuse or addiction that has become a problem of its own and can be fatal. Patients should never try to get medications that are controlled by the government in any way but through their own physician. Patients may have worsening pain problems due their underlying disease getting worse, but even then they should work with their doctor to find a solution and never adjust their medications on their own.

If you care about someone who is running out of their pain meds before they are supposed to, do not enable them by helping find another supply like in an emergency room. This will ultimately hurt them and you will feel guilty when it does. It would be best for the patient to tell their doctor the truth and go from there. Lies and deceit tend to backfire on those who do them.

 If the doctor prescribing for mom doesn`t know if your mom is addicted to drugs, then he/she can refer your mom to a drug addiction center that can gather all the facts and make a diagnosis and give treatment recommendations.

Web sites for further information can be found on www.nida.nih.gov under Prescription Medications.

Thanks for your question.

Related Resources:

Prescription Drugs (National Institute on Drug Abuse)

For more information:

Go to the Addiction and Substance Abuse health topic, where you can:

Response by:

Edna M Jones, MD, MRO Edna M Jones, MD, MRO
Emeritus Clinical Assistant Professor of Family Medicine
College of Medicine
The Ohio State University