This Week’s Topic: Hooked
There are several behavioral signs which raise a red flag that you should do some further investigation as to prescribed narcotic abuse:
Overwhelming focusing upon drug availability
Calls and visits solely to discuss and obtain medication
Stories as to why medication needs early refills
History of substance abuse including alcoholism
Obtaining medication from more than one source
Insistent preference for a specific short acting opioid
Lack of chronic pain indicators (no depression or anxiety)
No improvement despite large increases in dosage of the narcotic
Accusatory of doctors other than that prescribing the narcotic
Stating that pain is a 10 on a 1-10 scale all the time.
Indications of underlying personality disorder
Concurrent use of other habituating substances (e.g. marijuana, etc)
In these cases, order an evaluation to have a complete picture as to whether/how the patient’s life is increasingly defined by access to narcotics.