Possible Signs of Inappropriate Opioid Use by Patients

Patients taking opioids appropriately for pain management and those whose pain is inadequately relieved may occasionally display the behaviors listed below. However, the possibility of psychological dependence should be considered when a pattern of one or more of these behaviors is observed in patients. 

o     Multiple episodes of “lost” or stolen prescriptions o     Repeatedly running out of medication early

o     Aggressive complaints about the need for additional prescriptions

o     Drug hoarding during periods of reduced symptoms

o     Urgent calls or unscheduled visits

o     Injecting opioids intended for oral use

o     Using the medication to achieve euphoric effects

o     Unapproved use of prescribed opioid to self-medicate another problem, such as insomnia

o     Frequently missing appointments unless opioid renewal is expected

o     Unwillingness to try non-opioid treatments

o     Evidence of withdrawal symptoms visible at appointmentso     Concurrent alcohol or illicit drug abuse

o     Sedation, declining activity, sleep disturbances, or irritability unexplained by the pain or other co-occurring conditions

o     Deterioration of functioning at work, with family, or socially because of medication effects

o     Forging prescriptions or obtaining prescriptions from non-medical or multiple medical sources

o     Selling prescription medicines 

Reference: Center for Substance Abuse Treatment. Pain Management Without Psychological Dependence: A Guide for Healthcare Providers. Substance Abuse in Brief Fact Sheet Summer 2006, Volume 4, Issue 1. 

Web site: www.ncadi.samhsa.gov

 

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