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Quantifying drug-seeking behavior: a case control study.

Casey A Grover1, Reb J H Close, Erik D Wiele

  • 1Stanford/Kaiser Emergency Medicine Residency, Stanford University Medical Center, Stanford, California 94305, USA.

The Journal of Emergency Medicine
|October 1, 2011
PubMed
Summary
This summary is machine-generated.

Drug-seeking behavior in the Emergency Department (ED) is often indicated by specific actions. Requesting parenteral medication or reporting extreme pain are highly predictive of drug-seeking in ED patients.

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Area of Science:

  • Emergency Medicine
  • Clinical Psychology
  • Pharmacology

Background:

  • Drug-seeking behavior (DSB) is prevalent in Emergency Departments (EDs).
  • Existing literature on DSB in the ED relies heavily on anecdotal evidence.
  • Objective assessment of DSB indicators is needed.

Purpose of the Study:

  • To determine the relative frequency of specific behaviors indicative of DSB.
  • To compare the occurrence of these behaviors in suspected drug-seeking patients versus general ED patients.
  • To identify key indicators of DSB in an ED setting.

Main Methods:

  • A retrospective chart review was conducted.
  • 152 patients identified as drug-seeking were compared to age- and gender-matched controls.
  • Specific behaviors were analyzed, including medication requests, pain reporting, and visit frequency.

Main Results:

  • High odds ratios were observed for requesting medication by name (26.3), medication refills (19.2), and reporting multiple pain-related visits (29.3).
  • Reporting extreme pain (>10/10) and requesting parenteral medication yielded infinite odds ratios.
  • Non-narcotic allergies were less predictive (OR=3.4) compared to other behaviors.

Conclusions:

  • Requesting parenteral medication and reporting extreme pain are the strongest indicators of DSB in the ED.
  • Certain behaviors, such as reporting non-narcotic allergies, are less reliable predictors of DSB.
  • This study provides empirical data to aid in identifying DSB in emergency settings.