Doctors aren’t stupid. They know the pain medications they prescribe are highly prized on the black market, and they’re no stranger to addicts shuffling into their waiting room in hopes of getting a fix. Unfortunately, though, doctors’ skepticism can backfire when it targets patients who aren’t addicts at all. Drawing heavily on her own experiences as a chronic pain sufferer, Ania Onion Bula has penned a great list of factors that lead doctors to peg their patients as drug fiends, justly or not.
From Bar Crawl to Hospital Crawl
One red flag is hitting up multiple hospitals, which addicts do to avoid being recognized. This works for a while, since hospitals rarely communicate. But once doctors catch on to hospital-hoppers, they’re more likely to assume those patients are gaming the system. Unfortunately, some people have legitimate reasons to go to different hospitals. Commuters, for instance, might seek treatment downtown on a workday and back home in the suburbs on a weekend.
Acting as Doctor
People also look suspiciously like addicts when they request specific drugs or specific ways of taking them. Naturally, someone who explicitly asks for subcutaneous dilaudid will raise a few eyebrows in the ER. However, some people have allergic reactions to certain drugs or have trouble processing, say, any type of oral medication. These patients tend to have been in and out of many medical offices and know their own bodies very well, but once doctors suspect they’re chasing a high, their explanations often get discounted.
Preexisting Conditions
Additionally, patients who have psychiatric treatment listed on their medical records are more likely to be treated with skepticism at the doctor’s. In part, this stems from the stigma against mental illness. Patients with mental health histories are less likely to be trusted when it comes to describing their symptoms—or, frankly, anything—and may be suspected of trying to self-medicate if they ask for drugs.
Another group that faces an uphill battle are those with chronic pain, who are so accustomed to suffering that they may label some pain a “6” that a normal patient would call a “10.” Despite being able to converse and even laugh through the pain they’re used to enduring, they may find themselves “performing” their pain in order to convince doctors they do in fact merit treatment.
The Plight of the WASP
Perhaps most unfortunately (and predictably) of all, being anything other than a well-off white male can hurt your chances of getting the care you need. Thanks to enduring stereotypes, poor people and minorities risk being branded as addicts just by showing up. Women also struggle to convince doctors to take their self-reported pain levels seriously, as do young people whose symptoms are more typical of older patients.
Who Can You Trust? Not the Addicts
For a non-addict who falls into one or more of these categories, getting treatment for what are most likely debilitating and maybe even dangerous symptoms can be a waking nightmare. I can’t imagine a more frustrating and demoralizing experience than being wrongfully mistrusted by the one person I had trusted to help me. In her eye-opening piece, Bula recalls three separate occasions when she had to spend an hour at the doctor’s rolling in pain just to prove that the oral medication they’d given her would not, in fact, be effective.
Unfortunately, fellow addicts, this one’s on us. Not to pile on the shame and guilt, but this is just one more way that addicts inflict suffering on people they’ve never even met. By trying to manipulate doctors into giving us drugs, we’re ruining the system for people who actually need the meds. If you’ve ever conned your way to a prescription, make sure to reserve a spot for Bula in your Eighth Step.
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