As the prescribing practices of emergency providers come under enhanced scrutiny, watch for red flags of drug-seeking behavior.

With deaths from opioid medication-related overdoses reaching epidemic proportions, researchers at two academic medical centers in Boston have identified key characteristics or red-flags that patients may be exhibiting drug-seeking behavior. In a separate study, researchers note that the ED is a prime location for identifying and intervening with young people who are engaged in the non-medical use of opioid and sedative medications. Researchers have found that drug-seeking patients are more likely to request a narcotic by name, have multiple visits for the same complaint, report an allergy to non-narcotic drugs, have pain out of proportion to the exam, and visit the ED on weekends. When physicians compared their prescribing decisions based on their own impressions with data from a prescription drug monitoring program (PDMP), they changed their prescribing plan in 10% of cases. Physicians ended up writing more prescriptions for opioids once they had the PDMP data. Researchers at the University of Michigan in Ann Arbor found that one in 10 adolescents who presented to the ED between September 2010 and September 2011 reported that they engaged in non-prescription opioid or sedative use within the previous year.