Quantifying Drug-Seeking Behaviors in the Emergency Department

Pain is one of the most common reasons for patients seeking care in EDs, accounting for up to 42% of all emergency room visits. Emergency physicians vary widely in prescribing patterns and often have difficulty assessing patients’ level of pain. There may also be reluctance to provide pain medications due to concerns that patients are trying to obtain prescription drugs for non-therapeutic purposes. “These individuals— who are often labeled as drug-seeking—are a difficult group of patients to manage in the ED,” says Casey A. Grover, MD. “They often present to the ED with conditions that are difficult to evaluate, and may also engage in deceptive behaviors in an effort to fool clinicians into giving them additional medications.” It is estimated that up to 20% of all ED visits may be due to drug-seeking behavior. “Drug-seeking patients have been known to use large amounts of medical resources,” says Dr. Grover. “They may occupy beds in EDs that would be more appropriately used for people truly in need of emergency care.” Prescription drug abuse and misuse is a growing epidemic throughout the United States, and more and more emergency physicians are encountering drug-seeking patients in daily practice. “Despite the magnitude of the problem,” Dr. Grover says, “there is still much to learn about these patients, their patterns, and how best to manage them.” Intriguing New Data on Drug-Seeking Behavior Studies have been conducted on screening tools to identify drug-seeking behaviors in chronic pain patients, but few have provided quantitative data on such behaviors in the ED. With this in mind, Dr. Grover and colleagues performed a case-control study examining the relative...