title: Emergency management of chronic pain and drug-seeking behavior: an alternate perspective.
abstract: Pain is one of the most prevalent conditions treated by Emergency Physicians, although it remains contested how to interpret, measure, and treat this condition. In particular, there is controversy over how to identify and treat patients with chronic under-treated pain and those who are potentially malingering (drug-seeking). This article discusses currently accepted paradigms for treating potentially malingering patients, difficulties some communities may have when these paradigms are applied, and the results of implementing pain treatment guidelines that limit opioid use. Systematically limiting opioids via these guidelines was not associated with a decrease in overall patient satisfaction, patient satisfaction with pain management, overall volume, or volume of patients with potential drug-seeking diagnoses. Emergency Physicians' perception of quality of care delivered, as well as job satisfaction, increased after implementation of the guidelines.
authors.affiliation: Mountain Emergency Physicians-Blue Ridge HealthCare, Morganton, North Carolina, USA.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Hawkins
authors.forename: Frank
authors.initials: F
authors.lastname: Smeeks
authors.forename: John
authors.initials: J
authors.lastname: Hamel
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy; D019091:Critical Pathways; D004632:Emergency Medical Services; D006801:Humans; D008306:Malingering / Q000517:prevention & control*; D009293:Opioid-Related Disorders / Q000517:prevention & control; D010146:Pain / Q000188:drug therapy*; D017060:Patient Satisfaction
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal