Quantifying Drug-seeking Behavior: A Case Control Study

Grover, Casey A.; Close, Reb J.H.; Wiele, Erik D.; Villarreal, Kathy; Goldman, L.

doi:10.1016/j.jemermed.2011.05.065

Cited by 26 publications

(21 citation statements)

References 21 publications

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“…Further study is needed to validate or refute the reported associations of early or potent opioid prescribing with increased rates of disability. 51 Given the frequency of acute low back pain as an ED presentation and its association with perceived drug-seeking behavior, 78 and with apparent higher risk for misuse, 43 more attention needs to be paid to discriminatory historical or physical factors that may be predictive of drug-seeking or abuse to allow better matching of treatment modality for individual patients.…”

Section: Annals Of Emergency Medicine 507mentioning

confidence: 99%

Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department

Cantrill

Brown

Carlisle

et al. 2012

Annals of Emergency Medicine

214

172

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This clinical policy deals with critical issues in prescribing of opioids for adult patients treated in the emergency department (ED). This guideline is the result of the efforts of the American College of Emergency Physicians, in consultation with the Centers for Disease Control and Prevention, and the Food and Drug Administration. The critical questions addressed in this clinical policy are: (1) In the adult ED patient with noncancer pain for whom opioid prescriptions are considered, what is the utility of state prescription drug monitoring programs in identifying patients who are at high risk for opioid abuse? (2) In the adult ED patient with acute low back pain, are prescriptions for opioids more effective during the acute phase than other medications? (3) In the adult ED patient for whom opioid prescription is considered appropriate for treatment of new-onset acute pain, are short-acting schedule II opioids more effective than short-acting schedule III opioids? (4) In the adult ED patient with an acute exacerbation of noncancer chronic pain, do the benefits of prescribing opioids on discharge from the ED outweigh the potential harms?

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Section: Annals Of Emergency Medicine 507mentioning

confidence: 99%

Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department

Cantrill

Brown

Carlisle

et al. 2012

Annals of Emergency Medicine

214

172

View full text Add to dashboard Cite

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“…They either quantify the proportion of patients that misuse or divert their own medication 16 or focus on abusers or traffickers who were identified by law enforcement or health care providers. 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.…”

mentioning

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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“…Therefore, it seems practitioners administer more opioids 'if necessary' among patients suspected of drug use in an attempt to avoid potential conflicts. Studies comparing the request for opioids 'if necessary' between drug users and non-users of drugs found that drug users asked for medication more often than non-users (21)(22) .…”

Section: Discussionmentioning

confidence: 99%

Opioid analgesic administration in patients with suspected drug use

Kreling

Pimenta

2017

Rev. Bras. Enferm.

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Objective: To identify the prevalence of patients suspected of drug use according to the nursing professionals' judgement, and compare the behavior of these professionals in opioid administration when there is or there is no suspicion that patient is a drug user. Method: A cross-sectional study with 507 patients and 199 nursing professionals responsible for administering drugs to these patients. The Chi-Square test, Fisher's Exact and a signifi cance level of 5% were used for the analyzes. Results: The prevalence of suspected patients was 6.7%. The prevalence ratio of administration of opioid analgesics 'if necessary' is twice higher among patients suspected of drug use compared to patients not suspected of drug use (p = 0.037). Conclusion: The prevalence of patients suspected of drug use was similar to that of studies performed in emergency departments. Patients suspected of drug use receive more opioids than patients not suspected of drug use. Descriptors: Opioid Analgesics; Drug Abuse; Nursing; Pain; Patients. RESUMO Objetivo: Identifi car a prevalência de pacientes com suspeita de uso de drogas conforme opinião de profi ssionais de enfermagem e comparar a conduta desses profi ssionais na administração de opioides quando há ou não suspeita de que o paciente seja usuário de drogas. Método: Estudo transversal com 507 pacientes e 199 profi ssionais de enfermagem responsáveis pela administração de medicamentos a esses pacientes. Para as análises foram utilizados os testes de Qui-Quadrado, Exato de Fisher e um nível de signifi cância de 5%. Resultados: A prevalência de pacientes suspeitos foi 6,7%. A razão de prevalência de administração de analgésicos opioides "se necessário" é duas vezes maior entre os pacientes suspeitos em relação aos não suspeitos (p=0,037). Conclusão: A prevalência de suspeitos foi semelhante à de estudos realizados em departamentos de emergência. Os suspeitos de serem usuários de drogas recebem mais opioides do que os não suspeitos. Descritores: Analgésico Opióide; Abuso de Drogas; Enfermagem; Dor; Pacientes. RESUMEN Objetivo: Identifi car la prevalencia de pacientes con sospecha de uso de drogas de acuerdo con la opinión de los profesionales de enfermería y comparar el comportamiento de estos profesionales en la administración de opioides cuando hay o no hay sospecha de que el paciente sea un consumidor de drogas. Método: Estudio transversal con 507 pacientes y 199 enfermeras responsables de la administración de medicamentos a estos pacientes. Para el análisis se utilizó la prueba de Chi-cuadrado, la prueba exacta de Fisher y un nivel de signifi cación del 5%. Resultados: La prevalencia de pacientes con sospecha de uso de drogas fue del 6,7%. La razón de prevalencia de la administración de analgésicos opioides 'si es necesario' es dos veces mayor entre los pacientes con sospecha de uso de drogas en comparación a las personas sin sospecha de uso de drogas (p = 0,037). Conclusión: La prevalencia de los sospechosos fue similar a los estudios llevados a cabo en los servicios de urgenc...

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Quantifying Drug-seeking Behavior: A Case Control Study

Cited by 26 publications

References 21 publications

Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department

Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department

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

Opioid analgesic administration in patients with suspected drug use

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