Drug seeking behavior describes conduct where a patient attempts to obtain a prescription for a controlled pharmaceutical (typically a narcotic or benzodiazepine) without being in medical need of the drug. It can take many forms such as faking or mis-describing symptoms (typically pain or insomnia). When the prescription is denied, the patient often turns manipulative, abusive, hostile or, on occasion, violent.
There is no typical drug seeking patient. They can run the full range of social classes and can be completely healthy or have other real medical conditions. It can happen in patients of any age group from teenagers to the elderly.
When drug seeking behavior is identified, every effort should be made to divert the patient to a drug dependency program. The best defense is preventative. Physicians should consistently report all such prescriptions to a central registry kept to identify patients who may have a drug dependency but move from physician to physician and from pharmacist to pharmacist to avoid detection.
Doctors are trained to identify drug seeking behavior. The first set of criteria are behavioral cues such as:
- Aggressively complaining about the need for a drug
- Asking for specific drugs or brand names
- Requesting an increased dosage
- Stating that they have allergies or adverse reactions to several drugs
- Anger or irritability when questioned about symptoms
- Running out of drugs early, or seeking new prescriptions when they still have pills from their current prescription, or claiming they lost a previous prescription
- Injection sites where the drugs are not to be taken intravenously
- Not seeking drugs from their regular physician, including avoiding particular physicians in a multi-physician practice, often by calling about physician availability
- Disruptive behavior while waiting
- Refusal of safer medication
- Refusing a routine physical workup
- Using an alias
There are also techniques available to test the truthfulness of symptoms, such as placing pressure on the site of a pain while distracting the patient with conversation. In a patient with real pain, the patient will interrupt the conversation to complain.
In any event, all physicians, clinical practices and hospitals should have clear guidelines on prescribing such controlled substances.