How Frequently are "Classic" Drug-Seeing Behaviors used by Drug-Seeking Patients in the Emergency Department?

Grover, Casey A.; Elder, Joshua W.; Close, Reb J.H.; Curry, Sean M.

doi:10.5811/westjem.2012.4.11600

Cited by 37 publications

(26 citation statements)

References 27 publications

(21 reference statements)

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“…They suggest that ED providers need better ways of identifying patients attempting to obtain narcotics for non-therapeutic reasons (Grover, Elder, et al, 2012). The authors conclude that 'drug-seeking patients appear to exhibit 'classically' described drug-seeking behaviors relatively infrequently' (p. 418).…”

Section: (P 262)mentioning

confidence: 99%

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Drug‐seeking: A literature review (and an exemplar of stigmatization in nursing)

Copeland

2019

Nursing Inquiry

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Despite its lack of conceptual clarity and uniform definition, the term drug-seeking is used frequently by nurses from a variety of practice environments. The drugs patients are referred to as seeking are often pain medications. This is important because nursing has widely adopted a patient-centric definition of pain. Nursing also has a robust ethical code that places high value on human dignity and nurses' role in patient advocacy. A review of literature was conducted with the aims of describing whether/how the term drug-seeking has changed over time and to determine whether the use of the term in nursing literature is consistent with nursing values.Use of the term has shifted from objective counts of patient requests for medication to a confusing mixture of observable patient behavior and subjective interpretations of patient motivation. Its use is not consistent with nursing values. It is, in fact, a good illustration of stigmatization in nursing. Stigmatization is contrary to nursing values.Nurses in practice, research, education, authors, reviewers, and editors all have a role in ending this stigmatization. K E Y W O R D Sdrug-seeking, ethics, nurse, nursing practice, nursing values, patient relationship, stigma

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Section: (P 262)mentioning

confidence: 99%

“…The authors conclude that 'drug-seeking patients appear to exhibit 'classically' described drug-seeking behaviors relatively infrequently' (p. 418). They suggest that ED providers need better ways of identifying patients attempting to obtain narcotics for non-therapeutic reasons (Grover, Elder, et al, 2012).…”

Section: (P 16)mentioning

confidence: 99%

Drug‐seeking: A literature review (and an exemplar of stigmatization in nursing)

Copeland

2019

Nursing Inquiry

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“…4,6,17 Extant analyses also are largely limited to case or cohort studies, 18 self-reports of identified heavy users, 6 and analysis of records. 19 As a result, our knowledge of pharmaceutical diversion may be overly reliant on the experiences of heavy users, and little is known about those involved in physician deception who avoid medical or legal repercussions.…”

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confidence: 99%

Deception for Drugs: Self-Reported "Doctor Shopping" Among Young Adults

Stogner

Sanders

Miller

2014

The Journal of the American Board of Family Medicine

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Background: Pharmaceutical abuse is a burgeoning problem, and various forms of drug diversion are becoming more common. At present, little is known about those who attempt to deceive physicians to receive medications, and even less is known about those who successfully avoid detection and abuse-related repercussions. The goal of this study is to assess the prevalence of attempted physician deception in a general population, explore common motives, and evaluate risk factors associated with the behavior.Methods: A stratified random sampling technique was used to obtain a locally representative sample of 2349 young adults. The sample was 48.4% male, 68.9% white, 24.4% black, and 2.8% Hispanic. Selected individuals were surveyed using a self-report instrument (80.4% response rate).Results: Of the respondents, 93 (4.0%) self-reported having attempted to deceive a physician to obtain a pharmaceutical. Most of these indicated that they were at least partially motivated by their own abuse. Approximately half reported that selling a portion of the prescription was a motivating factor. Alcohol use, marijuana use, and pharmaceutical misuse each were risk factors associated with attempted deception. Although no traits were definitively linked to the behavior, attempted deception was more commonly reported by men, Hispanics, self-identified lesbian/gay/bisexual/transgender individuals, and those at the lowest and highest extremes of the income spectrum. Logistic regression models of rare events indicated that past substance use along with sexual orientation and family income were related to attempted deception when controlling for other factors.Conclusion: Results suggest that attempted physician deception may be more common than previously believed. Practicing physicians should attempt to use risk factor information presented within this study, albeit very cautiously. This study identifies general characteristics of young people who might divert medications but notes that only a small minority of any patient group will do so. Awareness should not equal bias in the treatment of these patients; instead, it should reinforce the need for careful clinical interviewing and the utilization of prescription drug monitoring programs and local law enforcement databases. (J Am Board Fam Med 2014;27:583-593.)

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“…[12] Additional factors that may infl uence the provider's risk perception of perpetuating opioid misuse include insuffi cient time to assess prescription history and fear of being manipulated by the patient. Interestingly, Grover et al [13] reported that providers face diffi culty in determining patients' motives, and this uncertainty impacts appropriate analgesia. We suspect that such barriers to adequate pain management may account for the perception among our EM providers that changing their prescribing behavior would not mitigate prescription opioid misuse.…”

Section: Discussionmentioning

confidence: 99%

Emergency medicine providers' opioid prescribing practices stratified by gender, age, and years in practice

Varney¹,

Bebarta²,

Mannina³

et al. 2016

World Journal of Emergency Medicine

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BACKGROUND: Emergency medicine providers (EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices. METHODS:We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire (100% response). Respondents were primarily younger male physicians (80%) in practice under fi ve years (55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse (P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would infl uence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.

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How Frequently are "Classic" Drug-Seeing Behaviors used by Drug-Seeking Patients in the Emergency Department?

Cited by 37 publications

References 27 publications

Drug‐seeking: A literature review (and an exemplar of stigmatization in nursing)

Drug‐seeking: A literature review (and an exemplar of stigmatization in nursing)

Deception for Drugs: Self-Reported "Doctor Shopping" Among Young Adults

Emergency medicine providers' opioid prescribing practices stratified by gender, age, and years in practice

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