Me: “Do you use drugs?”
Them: (Laughing, relaxed) “Yeah, do you have any?”
=No drug use
Me: “Do you use drugs?”
Them: (Older) “Yes” — fumbling in purse – ”metoprolol, lisinopril, vytorin…”
=No drug use
Me: “Do you use drugs?”
Them: (Hesitation, glance sideways)
=Marijuana
Me: “Do you use drugs?”
Them: (40’s, female, with chest pain, headache, and dizziness) “No.”
=Out of Ativan
Me: “Do you use drugs?”
Them: (Previous laminectomy, MRI in tow, applying for disability) “No.”
=Out of Vicoden
Me: “Do you use drugs?”
Them: (Junior high, limp, eyes closed) “mumble mumble.”
=Xanax bars
Me: “Do you use drugs?”
Them: “Yeah, but I’ve been clean for a week”
=Smoked crack last night
Me: “Do you use drugs?”
Them: (Angry, defiant, gazing past me) “Hell no.”
=Polydrug use
May 1, 2007 at 11:05 pm
You know…..you are very new to be so cynical. I like it.
May 2, 2007 at 4:47 am
I think ER years must be like dog years.
May 2, 2007 at 8:41 am
Here’s how I phrase the same question:
“Do you shoot up?”
Because I can careless if they smoke crack, snort cocaine, or inhale a l’il weed. It doesn’t change what I do for them and usually I can tell clinically if they have.
But if it’s an IVDA’er with a fever, then it’s a different story.
May 2, 2007 at 5:19 pm
very nice
although, i disagree with the above comment about only caring about IV drugs…sure do want to know if this is cocaine chest pain or not before you hit ‘em with the lopressor
May 3, 2007 at 11:55 am
Great, it is so true!
Please post more of this!
an ObGyn
May 3, 2007 at 11:19 pm
cocaine chest pain and lopressor, hehhehe. if ya can’t tell that they’ve been using cocaine by the looks of them…ah never mind!
this beta-blockers and cocaine chest pain business with fear of unopposed alpha activity, the evidence-based data is moderately so-so because the study sizes were small, but reasonably accepted as an axiom, nonetheless. use labetalol if you must since it has alpha-blockade as well. in my opinion, labetalol is a much better drug than lopressor in controlling hypertensive crisis while reasonably lowering heart rate.
the benefits of beta-blockade for AMIs are extended to the 12-24 hrs. window anyhow. if your cocaine chest painer doesn’t have a STEMI on arrival, why jump the gun and give lopressor when you got a while to wait for their utox to come back when your suspicion of cocaine use is high? which harks back to my original remark that a veteran ER doc can always tell if a patient has been smoking crack or using cocaine. you can control their hyperdynamic, sympathomimetic symptoms better with ativan as well.
i guess my point is, patients lie. they’ll lie about their drug use, so I don’t even bother to ask any more except to get my points under the social history sometimes. our triage charts is such that the nurses always mark off a box for smoking/drugs/drinking so i really don’t bother to ask much anymore. i can usually smell a cocaine chest painer after over 20 years of experience.
May 5, 2007 at 9:03 am
LOL…excellent post!
May 9, 2007 at 6:43 am
i just wanted you to know that I printed a copy of your post and stuck it up on the wall in our nurses station. I also plan on giving a copy to every new gradutate that comes to work on our unit:-)
MJ
May 9, 2007 at 3:54 pm
Thanks for telling me! That seriously makes my day.
10/10
May 15, 2007 at 11:28 am
mmmmmm…XANAX BARS…
yummyummyumm
August 14, 2007 at 10:13 pm
Good site, thanks!a
July 9, 2008 at 3:59 pm
lol
August 14, 2008 at 3:05 pm
Hence the reason you are in my blogroll.
October 9, 2008 at 2:51 am
[...] Do You Use Drugs? [...]
November 2, 2008 at 12:38 pm
Doctors are not exclusive from the drug abusing/addiction situation.
In fact, prescription drug abuse/addiction is highest among health care professionals. Next time you suspect someone may be drug seeking, it may actually be your colleague hitting the CII cabinet while you’re assisting patients you so often suspect that may actually be in, watch this….it’s coming….
legitimate pain! Doh!
December 4, 2008 at 10:16 pm
Hehe, reminds me of one I saw http://thedragonflyinitiative.blogspot.com/2008/04/medical-quote-of-day_26.html
Hadn’t smoked dope for 6 weeks except for “at 10pm last night”.
February 4, 2009 at 10:25 pm
Fascinating…I think you’re right on. Incredible for a layman to see how the truth of the situation is more or less opposite to the words coming out of patients’ mouths. Great post. Thanks!
March 9, 2009 at 10:41 am
I wish i still worked ER I just transferred out last weel to the ICU. If I was there I would so post this and the um ..what post in the ER. Soo hillarious.
April 24, 2009 at 3:33 am
I don’t even bother asking- “do you do drugs?”
My question is- “when was your last smoke/hit/pill?”
It is amazing how many people will actually deny drug use, but when I follow it with, “but when was the last time you did any meth, at all?” the answer is- “yesterday”