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Question of the Day


What are some warning signs or “red flags” for current opioid abuse?

Many examples of opioid abuse “red flags” have been described, and most of them are intuitive. The Federation of State Medical Board’s policy statement on opioids in chronic pain management lists some of these “red flags”, including the following: selling prescription drugs, forging prescriptions, frequently “losing” prescriptions, aggressively demanding opioids over other medications, intravenously injecting oral or topical opioids, escalating opioid doses without approval of the prescriber, concurrent use of illicit drugs, obtaining opioids from multiple prescribers, and failing a urine drug screen (e.g. absence of a prescribed drug in the urine of a patient reporting taking that medication as prescribed. This may suggest diversion). Other warning signs for opioid abuse include: requesting frequently abused non-opioid medications (e.g. stimulants), providing wrong contact information, borrowing drugs from friends, drug hoarding, and numerous allergies or intolerances to less addicting medications. -- Authored by R. Jason Yong, MD MBA, Mohammed A. Issa, MD, Chris Abrecht, MD, Ehren Nelson, MD