Is the Patient Really in Pain or Just a Drug Seeker?

When a person visits the doctor and says, “Doc I have lots of back pain and the only thing that helps me is Oxycontin, I’ve tried all the rest,” how is the doctor supposed to know if the person is for real?

There really are few objective tools to measure an individual’s pain to know if it’s real or faked. The Visual Analog Scale is widely used, but it’s a subjective rating from 0 to 10. There is another pain scale using facial expressions, which is great for children.

It is pretty well known that fifteen to twenty percent of people fake their symptoms to get narcotics. Either they are selling the pain meds or abusing them (or both), and faking pain is the best way to get drugs. Another reason for faking pain is to obtain a disability status, which can bring a nice income to people while the rest of society pays for it.

Narcotics represent the second leading reason for accidental death in America behind car accidents. The Office of National Drug Control Policy reports that opiate prescriptions are up 48% since 1999, while on the other side of the equation the Institute of Medicine reports that pain is often undertreated.

There are some well known red flags to patients who are “drug seekers”. Patients who call in saying they are from out of town and cannot obtain their medical records from their previous pain doctor are suspicious. Also, if a patient states they do not have insurance and want to pay cash for their treatment may be utilizing their insurance at another pain doctor and trying to hide that by skipping their insurance plan payments.

Over 35 states have instituted statewide prescription registries, where doctors can see if patients are receiving narcotics from other doctors. There are a few problems with the system, including the delay in prescriptions registering, incomplete participation, and the fact the systems cover only that individual state. A nationwide system, signed into effect by President Bush in 2005, has not been fully implemented due to lack of funding.

General practitioners handle 80% of pain medication prescriptions. It may be tricky. Even the best trained spine doctors may only get the diagnosis correct half of the time. The pain generator can elude detection, so deciding whether or not one is faking may be difficult to decide.

It’s not just inner city drug addicts who sell or abuse their prescriptions. Retired folks do it, executives do it, and even legitimate chronic pain patients take too much of their medications, effectively abusing them.

So what to do? Well, there are no foolproof detection methods. A few helpful tests include oral or urine drug screening, pain contracts, and as described the prescription registry system. Otherwise, simply be wary of red flags.

Want to find out more about the bestPhoenix AZ Chiropractors, then visit Preferred Pain Center’s site on how to choose the best Arizona Pain center for your needs.

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