When It’s Not Just About Opioid Use
Blanket Diagnoses Of Drug-Seeking Individuals In Hospitals
Opioid abuse is a real problem. A national survey by SAMHSA revealed that 10.1 million people aged 12 and over misused opioids in 2019. Of those, 9.7 million individuals misused prescription pain relievers. In 2020, 16,416 individuals died from an overdose of prescription opioids. Many of these individuals developed their addiction from taking opioids prescribed to treat acute pain and trauma. As a result, increased attention has been placed on the medical community for reigning in opioid use and abuse.
Against this backdrop, when a patient, who may also be a habitual drug user, goes to a doctor or hospital with any type of pain complaint, they often face discrimination and are accused of drug-seeking. In some circumstances that may be the situation, but there are instances when the patient has a legitimate health issue which is being dismissed.
One analysis coupled with interviews of drug-using patients and their treating physicians yielded some revealing observations:
Physicians are wary of being fooled by drug users. There may be a question of legitimacy when a patient with an apparent drug use problem claims to be experiencing pain and asks for opioids. The physician tended to question whether the patient’s self-reported symptoms were a sign of true medical need or the patient acting out of addiction.
There was no standard approach to this scenario. Assessing and treating patients in the light of possible opiate use or withdrawal puts many medical providers in a gray area when it comes to treatment protocols.
Physicians avoided engaging with patients to address their core complaints. Given the wariness and uncertainty of treating these patients, physicians were uncomfortable and uncertain in how to approach and work with them.
Patients were sensitive to receiving substandard care. Faced with a provider who is uncomfortable or a hospital that may be generally inefficient or lack clear treatment protocols, patients felt stigmatized and mistreated.
The practical result of this patient-provider dynamic can be exactly what these patients fear – failure to adequately diagnose or treat their core medical issue. And, for patients who go to the ER because of a drug overdose or withdrawal, the hospital’s failure to engage on their addiction or have treatment options may be the loss of a critical intervention point. Sadly, a patient does not need to be an actual drug user to be treated as one. Physicians sometimes make assumptions based on appearance, or symptoms that mimic those of drugs or alcohol.
The ”obvious” answer is not necessarily the right one. No one should be denied adequate medical care because of an apparent substance abuse issue. Awareness of the medical community’s own potential bias and trust concerns, however, is only the first step in ensuring these patients are provided with proper care. If you or a loved one have suffered because of a misdiagnosis or failure to treat, you may have options. Please get in touch with us.
