Patient with Drug Seeking behaviour

Question 1

Drug Abuse

Answer 1

= recurrent medication use outside acceptable standard recommendations & despite adverse consequences

Question 2

Addiction

Answer 2

= primary chronic neurobiological disease that develps as a result of genetic psychosocial & environmental factors

• impaired control
• over use
• compulsive use
• continuing use despite harmful effects & cravings

Question 3

Clinical Features

Answer 3

• previous drug seeking documented
• inconsistent hx or exam findings
• request specific narcotics/ drugs of dependence
• unwilling to try simple analgesia
• complaint lost or stolen prescription

PC: acute or chronic pain

• mental illness
• alcohol dependence

Risk:

• miss organic cause-
• px often self discharge
• miss opportunity to acknowledge dependence & refer

Question 4

Management

Answer 4

Recognize own frustrations/ feelings of being manipulated
approach:
- attempt to develop rapport with pt
- ensure new organic pathology doesn’t exist
- determine that genuine pain has been adequately Rx
- once physician has some degree certainty that problematic drug seeking behaviour exists set clear limits regarding med requests
- consider open discussion with px regarding behaviour
- consider referral to appropriate service
- develop mx protocol for particular pt if frequent attendance or threatening behaviour