• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Public Health

Clinical impression not reliable in identifying drug-seeking behavior

byAndrew Bishara
July 14, 2013
in Public Health, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD Neuronal growth cone

1. Emergency providers’ clinical impression was moderately sensitive and specific in identifying drug-seeking behavior, as defined by prescription drug monitoring criteria.

2. In approximately 1 in 10 cases, providers changed their prescription plan for patients after reviewing data from a drug monitoring program.

Evidence Rating Level: 2 (Good)

Study Rundown: Pain control in the emergency department (ED) setting remains a controversial topic – with data to suggest poor pain control in the ED and upon discharge on the one hand, and rising rates of opioid prescriptions, abuse, and overdose on the other. In an attempt to limit opioid abuse, many states have implemented prescription drug monitoring programs. In comparing emergency providers’ clinical impression of drug-seeking behavior with an objective definition of this behavior from a state monitoring program, this study demonstrates that providers’ ability to identify drug seekers was limited, with a tendency to overcall drug seeking.  These findings suggest that objective criteria from prescription drug monitoring programs may help health care providers balance providing appropriate analgesia without contributing to prescription drug misuse. However, these conclusions rest on the assumption that the investigator’s definition of drug-seeking behavior (greater than equal to 4 opioid prescriptions by greater than or equal to 4 providers in the prior 12 months) accurately captures patients’ “questionable activity” surrounding prescription medications. In order to fully ascertain the usefulness of drug monitoring programs in identifying problematic behavior, further research is necessary to determine how patient behavior in the ED predicts unfavorable outcomes such as opioid abuse and overdose.

Click to read the study in Annals of Emergency Medicine

RELATED REPORTS

Early acetaminophen use reduces mortality risk in patients with sepsis-associated encephalopathy

Artificial intelligence may assist in early detection of decreased ejection fraction on echocardiograms

Ocular trauma may be a predictor of mortality in geriatric patients

Relevant Reading: Undertreatment of acute pain in the emergency department: a challenge

In-Depth [prospective observational study]: compared emergency provider impression of drug-seeking behavior with objective criteria from Massachusetts’ prescription drug monitoring program. As secondary endpoints, investigators attempted to determine whether information from the prescription drug monitoring program changed prescribing behavior (and in what direction) and whether there are demographic or clinical factors associated with drug-seeking behavior. Thirty-eight emergency providers completed data forms on a convenience sample of 544 patients aged 18 to 64 years who presented to either of 2 medical centers with chief complaint of back pain, dental pain, or headache. Investigators calculated agreement between data forms (which recorded providers’ impression of drug-seeking likelihood, patient characteristics, and plan for prescribing) with the objective definition of drug-seeking behavior (patient had greater than equal to 4 opioid prescriptions by greater than or equal to 4 providers in the prior 12 months) from the state prescription drug monitoring program.

There was modest agreement between emergency provider impression of drug-seeking behavior and prescription drug monitoring program; providers had a sensitivity of 63.2% (95% CI 54.8-71.7%), specificity 72.7% (95% CI 68.4-77%), and positive predictive value 41.2% (95% CI 34.4-48.2%). Exposure to prescription drug monitoring program data changed providers’ plan to prescribe opioids in 9.5% of cases – 6.5% were prescribed opioids not previously planned while 3% no longer received opioids. A number of factors were shown to be significant predictors for drug-seeking behavior, including: requesting opioid medication by name (OR 1.91, 95% CI 1.13 to 3.23); multiple visits for same complaint (OR 2.5, CI 1.49 to 4.18), suspicious history (OR 1.88, 95% CI 1.1 to 3.19), symptoms out of proportion to exam (OR 1.83, 95% CI 1.1 to 3.03), and hospital site (OR 3.1, 95% CI 1.76-5.44).

By Elizabeth Kersten and Andrew Bishara

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

Tags: drug-seeking behaviordrugsemergency departmentemergency medicinepain controlprescriptions
Previous Post

Blindness and visual impairment decreasing worldwide

Next Post

Limited cardiovascular effect of diet and exercise in obese type II diabetics

RelatedReports

Emergency

Early acetaminophen use reduces mortality risk in patients with sepsis-associated encephalopathy

July 1, 2025
Lisinopril and carvedilol reduce cardiotoxicity in breast cancer patients receiving trastuzumab and anthracyclines
Cardiology

Artificial intelligence may assist in early detection of decreased ejection fraction on echocardiograms

June 19, 2025
Quick Take: Association of Visual Impairment With Economic Development Among Chinese Schoolchildren
Chronic Disease

Ocular trauma may be a predictor of mortality in geriatric patients

June 2, 2025
Chronic Disease

Bedside parameters may help predict chronic post-traumatic head and neck pain

May 25, 2025
Next Post
Exercise associated with lower pain ratings

Limited cardiovascular effect of diet and exercise in obese type II diabetics

Antidepressant may reduce mental stress-induced myocardial ischemia (REMIT Trial)

For ischemic mitral regurgitation, less surgery yields comparable results

High rate of hernia recurrence with biologic mesh repair

Perioperative protocol shortens stay after major gynecologic surgery

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • SGLT2 inhibitors may delay cognitive impairment in elderly patients with heart failure
  • Nerandomilast slows decline in FVC in idiopathic pulmonary fibrosis
  • Mazdutide significantly reduces weight in adults with overweight or obesity
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.