Opioid Tales – Games Patients Play

From our Executive Vice President, David Wroten:

I’m having dinner with one of my favorite physician friends a few weeks ago. He’s an anesthesiologist specializing in pain management. We don’t usually talk shop, but that night he was telling me about a recent experience with a patient (no, we don’t use names) faking a terminal illness to get opioids. I’m listening to this story with wide eyes and ask him if he had other similar stories. He did.

After hearing some of the tricks and lengths that some patients will go to in order to get narcotic drugs, I realized that other physicians are going through similar experiences and with all the efforts we are putting into addressing the opioid epidemic, this is one area we shouldn’t ignore. My thought was, could AMS use these types of stories to help educate other physicians about the types of behavior that drug seekers will use to scam a physician? Mind you, we are talking about people who are abusing the system, faking illnesses, and selling prescription pain medications.

The story in the November’s JAMS, titled “Dealing with Drug-Seeking Patients,” is our first effort. What comes next is really up to you, our AMS members. We want to share your stories in a new recurring column, “Opioid Tales – Games Patients Play.” It will last as long as members send stories to us. The goal is simple…. learn from others. Physicians go into an exam room expecting to see a patient who needs their help. Drug seekers know that and will use the physician’s compassion against them. It can be easy to be fooled. By sharing your experiences with your colleagues, they will learn the red flags of drug diversion and be better prepared to identify patients who are dishonest.

While I was writing this, I remembered another story from a couple of years ago where a patient had gone to a well-known office supply store, bought security paper, printed fake prescriptions and signed the physician’s name and DEA number. Thankfully, the physician was contacted by a local pharmacist familiar with his prescriptions, who recognized that the signature did not match the physician’s signature. However, by the time they found this out, the person had gone to five different pharmacies to get opioid drugs.

Then there was the story of the patient whose urine test showed an extremely high level of the prescribed opioid. At first glance, it simply appeared to indicate the patient was being compliant. On closer look it was obvious that the amount was abnormally high. Turns out the patient was crushing a single pill and putting it in the urine sample. The patient was selling their prescribed opioids and saving a single pill for their next visit.

I can go on……. but we would rather hear about your stories in…. “Opioid Tales – Games Patients Play”. They can be sent to Laura Haywood at lhaywood@arkmed.org.