Dr. Anna Lembke is the chief of addiction medicine and an assistant professor at Stanford University School of Medicine. She is also the author of the new book, Drug Dealer MD, which examines the layers of issues surrounding the prescription drug epidemic.
Dr. Lembke explains that the number of prescriptions for opioid prescription drugs quadrupled between 1999 and 2010. While attempting to better treat pain, the risk of overprescribing was underestimated, causing an epidemic involving a complex web of both patients and doctors.
Once addicted, the patient’s behavior is driven by a physiologic craving to use, causing them to go to great lengths to obtain the drug. Dr. Lembke describes several techniques that patients can use:
- Psychfance – Flattering the doctor and abusing the doctor-patient relationship.
- Senators – A filibuster technique where patients wait until the last 30 seconds of an appointment to ask for a prescription.
- Exhibitionists – Using dramatic displays of emotion or pain to communicate the need for the medication.
- Losers – Those who claim they lost their prescription or bottle of pills.
- Weekenders – Those who call in for an early refill on the weekend when their regular doctor is not around.
- Doctor shoppers – Patients who visit multiple doctors to get a similar or same prescription.
- Impersonators – Those who pretend to be different people to get multiple prescriptions.
- Dynamic Duo – Two against one, typically a patient and his/her mother.
- Twins – Anyone in the healthcare field with an addiction and who can navigate the system more cleverly.
- City Mice and Country Mice – Medically savvy patients and those who act unknowledgeable.
- Bullies – Patients who threaten to sue or call patient relations.
- Internet Copycats – Those who get advice on the internet about deceiving doctors.
- Little Engines That Could – Those who want to get off the medication, but continue to have excuses as to why they need to refill.