Patients Seeking Drugs

Drug Seeking

A Wichita dentist believes a patient may have attempted to fraudulently obtain prescription drugs, claiming to be new to the city and using various aliases.  When asked for identification, the patient went to the car and drove off.  According to the dentist, “All other information on the form is fraudulent upon verification.”

The patient is a Caucasian female, mid to late ’30’s with blonde hair.  She had a male child, approximately aged four.  The patient may be actively seeking prescription drugs using upward to thirty different aliases.

Related: CDC to interview dentists on state prescription drug monitoring programs

As a dentist, particularly when prescribing drugs, you have a high responsibility to help protect society from drug abuse.  Under KSA 21-36a08, providing false information to a practitioner or mid-level practitioner for the purpose of obtaining a prescription only drug is a class A nonperson misdemeanor, except when the  person intends to distribute.  The dentist can and should notify authorities if it is believed that a patient is seeking drugs unlawfully.

A program known as K-TRACS tracks all schedule II, III and IV controlled substance prescriptions and drugs of concerns dispensed to patients in the state of Kansas.  Dentists can sign up for the free program by visiting https://pmpaware.net. or by contacting the Kansas Board of Pharmacy at 785-296-4056.  The dentist can simply enter the first and last name of the patient along with the date of birth and pull the  prescription history of that patient since 2010 of those controlled substances distributed in Kansas.

 

The United States Department of Justice published guidelines to help recognize a drug abuser and the methods often used to try and seek drugs:

Common Characteristics of the Drug Abuser:

  • Unusual behavior in the waiting room;
  • Assertive personality, often demanding immediate action;
  • Unusual appearance – extremes of either slovenliness or being over-dressed;
  • May show unusual knowledge of controlled substances and/or gives medical history with textbook symptoms OR gives evasive or vague answers to questions regarding medical history;
  • Reluctant or unwilling to provide reference information. Usually has no regular doctor and often no health insurance;
  • Will often request a specific controlled drug and is reluctant to try a different drug;
  • Generally has no interest in diagnosis – fails to keep appointments for further diagnostic tests or refuses to see another practitioner for consultation;
  • May exaggerate medical problems and/or simulate symptoms;
  • May exhibit mood disturbances, suicidal thoughts, lack of impulse control, thought disorders, and/or sexual dysfunction;
  • Cutaneous signs of drug abuse – skin tracks and related scars on the neck, axilla, forearm, wrist, foot and ankle. Such marks are usually multiple, hyper-pigmented and linear. New lesions may be inflamed. Shows signs of “pop” scars from subcutaneous injections.

Modus Operandi Often Used by the Drug-Seeking Patient Include:

  • Must be seen right away;
  • Wants an appointment toward end of office hours;
  • Calls or comes in after regular hours;
  • States he/she’s traveling through town, visiting friends or relatives (not a permanent resident);
  • Feigns physical problems, such as abdominal or back pain, kidney stone, or migraine headache in an effort to obtain narcotic drugs;
  • Feigns psychological problems, such as anxiety, insomnia, fatigue or depression in an effort to obtain stimulants or depressants;
  • States that specific non-narcotic analgesics do not work or that he/she is allergic to them;
  • Contends to be a patient of a practitioner who is currently unavailable or will not give the name of a primary or reference physician;
  • States that a prescription has been lost or stolen and needs replacing;
  • Deceives the practitioner, such as by requesting refills more often than originally prescribed;
  • Pressures the practitioner by eliciting sympathy or guilt or by direct threats;
  • Utilizes a child or an elderly person when seeking methylphenidate or pain medication.

 

What You Should Do When Confronted by a Suspected Drug Abuser

DO:

  • perform a thorough examination appropriate to the condition.
  • document examination results and questions you asked the patient.
  • request picture I.D., or other I.D. and Social Security number. Photocopy these documents and include in the patient’s record.
  • call a previous practitioner, pharmacist or hospital to confirm patient’s story.
  • confirm a telephone number, if provided by the patient.
  • confirm the current address at each visit.
  • write prescriptions for limited quantities.

DON’T:

  • “take their word for it” when you are suspicious.
  • dispense drugs just to get rid of drug-seeking patients.
  • prescribe, dispense or administer controlled substances outside the scope of your professional practice or in the absence of a formal practitioner-patient relationship.

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