Clinical Features

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Because of the spectrum of drug-seeking patients, the history given may be factual or fraudulent. Drug seekers may be demanding, intimidating, or flattering. In one ED study, the most common complaints of patients who were drug seeking were (in decreasing order): back pain, headache, extremity pain, and dental pain. 23 Patients may complain of panic disorder or drug withdrawal symptoms and request benzodiazepines. Additional fraudulent techniques are listed in Iab]e,3.4-4.. In some cases, observations of vital signs and physical examination findings will help the physician identify factitious illness, but even experienced clinicians are frequently misled.23

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