The Danger of Treating ER Patients as Drug Seekers
http://www.painnewsnetwork.org/stories/2016/1/13/the-danger-of-treating-er-patients-as-drug-seekers
By Emily Ulrich, Columnist
Recently the news has been covering the story of Barbara Dawson, a Florida woman who was arrested after she refused to leave a hospital that would not treat her for abdominal pain. While being escorted from the hospital in handcuffs, she collapsed in the parking lot and later died.
For many of us who are chronic pain patients, this kind of treatment is all too familiar. More often than not, when doctors see that we are on pain medications, they automatically assume that we are drug addicts and that we are “drug-seeking” just by going to the hospital.
Personally, I have so many of these experiences, that I couldn’t possibly list them all. Last year, I was hospitalized for upper abdominal pain. I had been to the emergency room earlier that week for the same issue, so the doctor told me he was admitting me, “Because otherwise you’ll just keep coming back.”
On my first day after being admitted, I was given no pain control and was taken off of my muscle relaxers. I got no sleep. I was told there was absolutely nothing wrong, and they couldn’t find any reason to keep me. I overheard my nurse speaking to another nurse, saying that my liver enzymes were in the thousands.
I questioned the doctor, who was in the process of discharging me, about my liver enzymes. He asked how I knew about this. I claimed that I had asked the nurse, because I could tell he was angry and I didn’t want to get her in trouble, although I had every right to know this potentially life threatening information. At that point, he felt pressured to keep me and try to figure out what was wrong.
Because they weren’t treating my pain, my blood pressure was high and I was at risk of heart attack or stroke. Instead of treating my pain, they put me on two different blood pressure medications.
At one point, I was taken to another floor for an abdominal scan. I was in so much pain I was trembling. A nurse said, “So, you’re an addict. When’s the last time you used?”
I was dumbfounded. I replied that I was absolutely not an addict and asked why she said this.
“Oh, maybe I used the wrong terminology,” the nurse said. “You’ve been on pain meds for a long time, right?”
I said yes and she said, “Well, okay. You can’t deny that, then. I just used the wrong word, sorry.”
I was suddenly acutely aware of the frequent misuse of the term “LTDU” (long term drug user), which is applied to many of us who take pain medications.
Upon transfer from my room to the exam room, I was given my medical records to hold. I opened and read them. Not surprisingly, I saw multiple remarks about “drug seeking behavior.” The nurse told me I was not allowed to read my own records. I said, “I’m allowed to hold them, but not read them? They’re mine!”
“Yes. Well, it’s hospital policy,” she replied.
I was hospitalized a second time last year, for the same issue, plus bradycardia. The admitting doctor was nasty to me, saying, “I am admitting you, but you will not be given one drop of pain medication other than Tylenol.”
Eventually, I was given a small dose of pain medication, but I was still trembling and vomiting the pain was so bad; yet the doctors refused to raise my dosage. I called the nurse, who got me a patient controlled pain pump. This was slightly more helpful, but when I let them know that the dosage was not controlling my pain, they took it away entirely. The gastrointestinal team came in and talked to me, but never came back.
I was discharged within three days, with no answers. Over those three days, I was told by one nurse, “If you call me every time it’s time for your medication, you are called a ‘clock watcher,’ which we consider a form of drug-seeking.”
I was again gobsmacked. Later, another doctor came in and said, “We have no reason to believe you’re in pain.”
I said, “Why would I go through all of this just to get a mediocre amount of pain medicine?! I’m not drug-seeking, I’m relief-seeking!”
The doctor said, “Well, there’s not much difference.”
During this second stay, I had to call the charge nurse and often the patient advocate, just to get minimal pain control. Every time, I pointed out their sign, which said “If your pain is not relieved within 30 minutes, please tell your nurse. Our goal is to treat patients with respect and dignity.”
I pointed this out so many times that instead of heading their own policies, they literally changed the sign! They came in and screwed a new sign to the wall, which mentioned nothing about pain care or patient rights.
In August of 2014, before the two events described above, I had my gallbladder removed. I was already on pain medications for chronic pain and I expressed concern to the doctor that my pain after surgery would not be adequately controlled. He said, “Don’t worry. You’ll get your precious Percocet. One prescription, that’s it!”
I was hurt and offended that he was treating me this way, as though I would have an organ removed just to get pain medicine! But, it got worse. As I was waking up from surgery, my eyes were not yet open, and I heard one nurse say to another, “The doctor said she’s going to claim she’s in pain, but just get her out of here.”
I opened my eyes and declared, “I heard you!” They both grew silent, and pretended that never happened.
This past August, on my 40th birthday, I landed in the ER again. Again, I had severe upper abdominal pain and was told that, “Nothing is wrong, and you will not be given narcotic medication.”
I asked the doctor to look at my liver enzymes. He saw that they were extremely elevated, and gave me a dose of pain medicine. The next thing I knew, the admitting doctor was in the room, telling me that I was “getting what I wanted” and I was going to be admitted. She introduced herself, and then proceeded to verbally steam roll me, telling me that I would not receive pain medications while I was in “her hospital.” She told me that I was already “unnecessarily on pain medicines.”
I questioned her, but she curtly cut me off. “I see that you have a bunch of ‘garbage pail diagnoses,’” she said.
I was furious. I asked if she even knew what some of them where, and if she knew better than the doctors from “her” hospital who had made those diagnoses. She rolled her eyes, and continued with her speech on the lack of treatment I would receive while admitted.
I said, “So, I’m being admitted for pain control and further testing, but I won’t receive pain control beyond the medications I currently take?”
“That is correct,” she said, her snide attitude seething. I told her that it was my 40th birthday and the last place I wanted to be was in the hospital, but I really wanted some answers. She just stared at me. I decided that I would take my chances, and go home. If this was any indication of the abusive treatment I was in for if I stayed, I wanted no part of it.
I was discharged with a diagnosis of intractable abdominal pain. Three weeks later, I looked at my online medical records, and noticed that my diagnosis had been changed to “narcotic withdrawal.”
Four years ago, I developed a severe kidney infection. I was deemed a drug-seeker by numerous ER’s, without any testing for my symptoms. Eventually, a doctor took me seriously, but by then, I was developing sepsis, and my life was in danger. You can read the full story here.
Even during this horrible incident, I was taken off my regular pain medication and was given a tiny dose of IV pain medicine, equivalent to about half of my home medications. The nurses watched me writhe and cry in pain all day and night, until I spent two days in and out of consciousness. They argued with the doctor on my behalf and I argued with him, but nothing changed. I was still supposedly “drug seeking.”
I could go on and on, but I think by now you get the point. Our lives are in danger, on the off chance that doctors may accidentally give medicine to someone who is trying to get high. This is absolutely unacceptable.
Also, I’m not sure how much validity is behind their theory. It seems to me that if someone wanted to get high, buying drugs off the street would be much easier and cheaper. Like most of us who take pain medication to treat our pain, I do not feel any euphoria, just a little relief.
How is this kind of behavior in line with a doctor’s Hippocratic oath to “First, do no harm?” It seems the oath is now “First, judge and abuse.”
Filed under: General Problems
I am once again enraged reading this.
I will not go to a hospital ever again, I had severe chest pain, couldn’t breath etc. an ambulance even took me in. Felt so demeaned, humiliated and browbeat and never did find out what was actually wrong that upon discharge if a bus had been driving by when leaving I would’ve walked right in front of it. These people are inhumane, unfeeling clones of the previous caring professionals that used to be, it’s absolutely appalling!
Amen Kriss,,ditto,,About 2 weeks ago,,I wrote up my medical symptom’s,,got a pain management body diagram, Marked my area of forced physical pain,,Add’d it my medical records along w/ pictures of all the swelling every day,,,With a letter,,stating,,this is where ,my physical pain is,These are my medical symptom’s,,If any are actually interested in helping a medically ill person by finding the cause via a 3 x Doctor recommended laparoscope,,,Call me,,Anyone else,,,my autopsy will prove it,,then,,,u all better hide,,For your cherry picken,your Evidence Base stupidity just killed another!!!,,I will never go to another E.R./.,,Hospital,,or Doctor,,Unless I am dead,or passed out,,etc.And if any take away what little medicine I do get,,that autopsy will come a lot sooner,,,maryw
Very sad but absolutely true. Until hospitals start getting sued for their mistreating of patients all this will continue to happen. It’s not that anyone of us wish to get rich by suing, we just want proper treatment both morally and physically. The fact that all long term pain medicine users are automatically deemed as drug seekers if they have to go to the ER, it is the most dangerous form of inhumane discrimination there is these days. I have told ER doctors in the past that I wish I didn’t have to take narcotics and if they could find a workable non-opiate solution for treating my chronic pain that I would be the first to sign up for it. Don’t judge me or anyone like me. We all wish we could live normal lives without needing pain relief. We all wish we could climb a flight of stairs without having to rest afterwards. This discrimination needs to stop and it’s up to us to make it happen. Start picketing these hospitals. Start raising your voices to the news media. Just flat out get pissed because until we make a scene, we won’t be recognized as legitimate suffers.
I sure hope she turned this story in to her BOME, thinking about it I wonder if it would do any good. I have been treated really good by our ER staff but I get phone calls from people who are not being treated good at all. The story’s I hear coming out of ER’s in bigger city’s are horrible. The people who are drug seekers have put people suffering in chronic pain where we are today. There is another lady I correspond with on FB going through a similar situation. What are we supposed to do? Jeopardize our freedom by going to the streets for help? That’s what it is coming down to. With the new DEA guidelines on Opiates street drug sales are going to be booming. I was recently informed that Gabepentin is now a big seller at $3.00 per pill. Anti depressant’s are also now being “snorted” by users. It is bad now and is only going to get worse. I hope this lady found some help after all she has been through!!
Was this a rural hospital? They are the absolute worst, they get doctors that nobody else wants, and, good doctors do not typically go to rural hospitals because they can not make the money that they could make in larger cities. I live in a rural area and will not go to the local hospital because your story sounds just like something that comes from there. My advice is to go to another hospital, a larger hospital will not typically behave like this, they want your pain under control so they can talk to you .I have had good luck in the hospitals I go to, I am glad I don’t have to go very often.
The sad thing is that this is all too common a story & not just w/ ER’s. Many CPP, myself included, avoid going to docs for things that have nothing to do w/ our CP cond. I have had problems my whole life w/ my stomach & digestive system. I had been on oxycontin for about 7 yrs. when they changed it. 2wks later, I was in so much pain I thought I would die. However every doc I went to said that it was all due to opioids; but I had been on them for years w/o problems. My pain doc told me that he had other pts. that were having the same problems w/ the new oxycontin, but said that he could not change it because it would look like that I had been doing well for years & now because it cannot be abused, all of a sudden it was not working & causing me pain, & therefore I would be flagged as a drug seeker!
We are judged the moment they see our charts before even meeting us! I have had docs walk in to meet me for the 1st time & the 1st thing out of their mouths is, “I will not give you any narcotics, so if that is why you are here you might as well leave”! No matter why you are there, this is how we are treated! I would just about rather die than go to the er for any reason & many pts feel the same!
The last time I was forced to go w/o my meds. (due to a “floating” pharm at the cvs I had been going to for 10+ yrs.refusing to fill because he was uncomfortable & no other pharm had it in stock!) I tried to explain this to the er doc; but it was a weekend & I was told that is when drug seekers come to score & that they could not help until Monday & sent me home. That was fri. on sat. I had a stroke & was in the icu for over a week as my heart stopped twice due to withdrawal shock!
Because of Celebrex causing me to have congestive heart failure & uncontrollable extremely high bp, it has made the stress of pain & especially withdrawal to become very dangerous to my life, but docs do not care if we have to suffer or die as it seems the only lives that matter are those that abuse & OD on a med that they should not even be on and if it kills a bunch of innocent patients that actually NEEDS these meds. oh well! After all, everyone knows that only those on their death beds deserve pain relief & that CPP just need to suck it up, admit that we are addicts because opioids have no benefit for long term CP relief & jump on the suboxon train to nowhere!!