Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Distortion

Distortion

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.

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