ELIZABETHTON �'' Doctors and nurses at Sycamore Shoals Hospital say they are keeping an eye out for patients who are requesting pain medication for more than just an aching back.

Emergency room personnel say some patients will go to great lengths to try to score a prescription for painkillers like Lortab or Percocet for recreational use.

�''We call them �''frequent flyers,�'' �'' Cindy Phillips, clinical director of the hospital�''s emergency department, said last week. �''These are people we see frequently for a variety of complaints like a backache, toothache or severe headache.�''

Generally, these complaints all lead to the same request.

�''The bottom line is they are seeking pain medicine,�'' she said.

Phillips said a �''red flag�'' goes up among emergency room personnel whenever a patient comes to the hospital asking for a specific prescription drug to relieve his or her pain.

�''If they ask for Lortab or Dilaudid by name, we get suspicious,�'' Phillips said. �''Another red flag goes up when they tell you they are allergic to one medication but they can take another.�''

While she says there is no one stereotype to use in spotting drug abusers, Phillips often becomes suspicious when she finds a patient in his or her early 20s seeking medication for acute pain.

Phillips said she and other hospital personnel are also seeing problems with patients who use false information in an attempt to obtain prescription painkillers. She said a couple was recently arrested in the emergency room while attempting to obtain drugs by using fake identification.

Dr. E.C. Goulding, SSH medical director for emergency services, said new technology has helped him and his colleagues in spotting patients who are seeking prescription drugs for things other than pain management. Goulding, who practices in the emergency rooms of a number of local Mountain States Health Alliance hospitals, said better record keeping has aided in that effort.

�''Physicians are reporting things now more than they used to,�'' he said. �''We can tell you now if a patient has been seen in an another emergency room within the past few days.�''

Such was the case with a man who was seeking pain medication for a broken arm he had suffered 10 years before. Goulding said a radiologist had taken a X-ray of the arm at one hospital, only to see the same X-ray (and the same man) show up again eight hours later at another MSHA hospital.

Recently, Goulding said he saw a patient at Indian Path Medical Center, Kingsport, for a toothache. A few days later, the doctor said he was working in the emergency room at North Side Hospital, Johnson City, when the same man showed up to there looking for pain medication for back pain.

�''I think he was a little surprised to see me,�'' Goulding said.

Emergency room workers say they have heard many incredible stories over the years from patients who arrive at their hospital seeking prescription drugs. One that stands out in his mind, Goulding said last week, was the man who showed up to the hospital claiming he was in extreme pain from passing a kidney stone.

�''The patient showed me a piece of gravel that he probably picked up from the driveway,�'' Goulding said. �''He said it was a kidney stone he had just passed.�''

While hospital officials say some of the stories they have heard are humorous in retrospect, they also believe the drug problem in Carter County is no laughing matter. Scott Williams, SSH administrator, said Wednesday there is a �''prevalent drug problem�'' in the county.

Williams said the consequences of that abuse can often be seen at his hospital.

�''I�''ve had one physician tell me he had to kick a patient out of his office when he found him shooting up,�'' Williams said.

The administrator said another doctor told him that a patient became indignant when the physician refused to prescribe him the drugs he was seeking.

�''He told the physician he could walk out of the front door of his office and go the curb and get any drug he wanted,�'' Williams said. �''He said the drug dealers would pull over for him.�''

Goulding said that is one of the reasons physicians are careful in limiting the amount of pain medication they prescribe to the patients they see in the emergency room.

�''When we give out a prescription for Lortab or OxyContin in the ER, it�''s for a low dosage,�'' he said. �''That does not prevent some people from trying to change what was written as four tablets on a prescription to 41. Then they try to sell them on the street.�''

Hospital officials say nearly 20 percent of the patients who come to the emergency room may be seeking prescription drugs under false pretenses.

�''The people who abuse drugs make it hard for those patients who really need medication for pain,�'' Goulding said. �''When you see so many people in the ER trying to get pain medicine under false pretenses, you get to be suspicious.�''

  • Drug Facts
  • Dilaudid addiction can consume a person and become an obsession driven by physical dependence.
  • Dilaudid is approximately 8 times more potent on a milligram basis than morphine.
  • Withdrawal symptoms from Dilaudid can occur, 4 to 5 hours after the last dose.
  • Dilaudid inhibits the ascending pain pathways in the central nervous system, increases the pain threshold and alters pain perception.
  • Dilaudid, or Hydromorphone, is a narcotic analgesic prescribed for the relief of moderate to severe pain, such as burns, cancer, Kidney stones or surgery.