As dental professionals, we strive to provide a pain-free experience to our patients. We use topical and local anesthesia to alleviate pain during the procedure, use our tactile grace to ensure that our patients have a positive dental visit, and prescribe our patients with pain medications after certain procedures to ease the recovery. However, when a patient comes into our office complaining of pain, how can we distinguish whether they are genuinely in pain or in search of pain medication for non-medical related reasons? Chances are, you will encounter this fraudulent seeking of prescription medications in your practice, known as “drug shopping.” According to the National Alliance for Model State Drug Laws, approximately 20% of people in the United States have used prescription drugs for non-medical reasons. Here are some red flags to look for in a patient who is “drug shopping:”
If a patient claims to be in pain, but the story surrounding the onset or timeline of pain is inconsistent, be wary. Also, the patient may state he/she has dental pain, but be nonspecific as to where the pain is coming from.
Watch out for patients claiming to be in excruciating pain that interferes with their daily routine, yet they appear not to be in distress during the appointment and walk out the door like nothing is wrong.
Ask for a specific prescription:
Always be skeptical if a patient comes in asking for a particular medication. They may claim to be allergic to alternate medications or have experienced bad side effects from them to direct you toward prescribing the medication of interest.
Ask for multiple refills:
The patient may ask for a refill in case the pain gets really bad or persists. Also, a patient may claim that he/she lost their medications or the pills fell on the ground.
Emphasize the pain rather than the symptoms causing the pain:
Be alert if a patient focuses solely on the pain aspect of their problem, rather than the symptoms or the problem eliciting the pain. For instance, if a patient thinks he/she might need a root canal, but he/she is more concerned with obtaining painkillers than treating his/her dental needs.
Be cognizant of the patient’s behavior and body language. A person who is not telling the truth may avoid eye contact and may make jittery body movements. The patient may stutter and be hesitant when answering questions. Also, a person who is abusing opiates will have constricted pupils and may appear tired and drowsy .
Patients have gone to many doctors for prescriptions:
Most states have their own prescription drug monitoring programs (PDMPs), which is an electronic database that tracks the dispensation of controlled substance. These PDMPs are regulated by statewide agencies and are completely separate from the DEA. It is important to consult this database if you suspect a case of “drug shopping” in your dental practice.
What other clues should we look for to spot a “drug shopper?” Feel free to share your advice and stories.
~Allison Greenberg, Stony Brook ’16, chapter president