Pain Management Patients in the Emergency Room

In every emergency department in the US, chronic pain is one of the most common symptoms reported. Research has shown that about forty percent of individuals who come in to the emergency room describe a chronic pain syndrome. This is truly not very alarming considering the Institute of Medicine survey from last year showed that over 30% of America is dealing with a pain issue.

The largest problem when people present to the ER with chronic is that doctors must decide between genuine pain management patients and those who are there just looking for illegitimate prescription narcotics.

Any prescription opiate with a street value is going to be obtained potentially under suspicious motives. Many will fake a painful condition to obtain an opiate prescription illegally so that they can sell or barter the narcotic and make money from it. A usual profile of a person who plans to sell or barter narcotics is a younger, well groomed person who knows a lot of medical terms. It may even make the doctor think the person is in a medical field he or she knows so much.

The person will claim to have an issue like or headaches such as migraines, back pain, maybe something off the wall like a sickle cell crisis, or potentially another problem that would lead into the type of opiate medication being looked for. When these people show up in the ER, they often ask for a specific drug, have a problem producing ID, refuse a complete workup, produce weird stories, and claim to have allergies that are very specific.

If the ER has signed up for a prescription drug monitoring program they can check and see if the person has been getting controlled substances already from multiple physicians.

Emergency doctors and ER personnel should ask for multiple types of ID along with talking to the patient's primary care physician. If there are just a lot of red flags, the local police should be called.

Patients who are addicts often have common features. There is often drug escalation along with the person using alcohol or illicit drugs too. People will obtain their opiates from nonmedical sources, and "doctor shop".

At times, even legitimate individuals in the ER may show signs of dozing off, slurred speech, and an overall appearance of being high. This is often why legitimate people get labeled as "drug seekers" because of their appearance and actions while in the ER.

In order to protect themselves, ER's often give out limited amount of opiates to these folks. This would not be enough to abuse or overdose with, but enough to reduce pain for 2 to 3 days until the patient can get in with their regular physician.

The emergency room is not the time to eliminate substance abuse, and it is also not the time to provide enough opiates to promote substance abuse. Ensuring a common sense approach and only providing limited opiates makes complete sense.