Drug Seeking Behavior in ER Doubles, Feeds Growing Addiction to Pain Pills

VIDEO: Vanderbilts Dr. Peter Martin: Addicts put ER docs in a tricky situation.
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Sherry Ragan tracked down her brother in a local Utah Emergency Room. He wasn't hurt or sick; he had run out of Adderall and needed a new prescription to feed his addiction to the drug.

Ragan told the nurse and the doctor about her brother's drug-seeking behavior, and that he and his doctor had been trying to wean him off the drug. But the doctor said he'd give him a little bit of Adderall despite her concerns. Ragan said she's not sure whether the doctor didn't have the time, didn't want to be bothered, or he was simply not well-versed in substance abuse. At any rate, she was upset by the outcome.

"If my brother can do this, that means everyone coming here can get whatever they want," said Ragan, a Utah County Drug Prosecutor. "I work with people who work their whole lives trying to help addicts, and to find out that we're being undercut was really shocking."

Janet Frank, spokesperson for Intermountain Healthcare, which includes American Fork Hospital under its umbrella, said, "We don't have permission to talk about that instance due to federal privacy laws, but we are acutely aware of the prescription drug problem in our community as well as across the nation, and all of our staff in all of our staff are committed to being a part of the solution."

Although Adderall is not a pain medication, which is the more common sought-after type of drugs in emergency rooms, the story brings to light a growing problem of prescription drug addicts who find their fix in the ER. According to the Centers for Disease Control and Prevention, the number of ER visits that involved non-medical use of narcotic pain medications more than doubled in the United States between 2004 and 2008.

"This is a huge issue for emergency departments because, unlike the office setting, the ED treatment of pain is frequently indicated without the benefit of an established doctor-patient relationship and often in an environment of limited resources," said Dr. Jason Hoppe, assistant professor in the department of Emergency Medicine at the University of Colorado School of Medicine.

According to Hoppe, prescription opioids are currently the number one cause of poisoning deaths in the country, surpassing cocaine and heroin as causes of drug associated death.

"This problem has increased tremendously over the past years," said Dr. Ziad Kazzi, an assistant professor of Emergency Medicine at Emory University. "It is hard for me to estimate its frequency in my practice but I would like to say it is at least once per shift."

A Well-Known Problem Discussed Everywhere

The issue of drug-seeking ER patients is a well-known problem. The topic has been featured in popular medical dramas, discussed on blogs, written about in editorials, and even vented through Craigslist posts.

One anonymous Craigslist post, written by a supposed doctor who was frustrated by drug seekers in his ER, wrote the 2007 post entitled, "Advice from an ER Doctor to Drug Seekers." The satirical writing gives doctor's advice for people seeking pain medication without the needed pain.

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