Ihe diagnosis of drug-seeking behavior may not be possible in the ED. Ihe medical record can provide a wealth of information regarding the patient, including documentation proving the patient is supplying false information. Often the diagnosis is suspected in the ED but cannot be confirmed. In such cases, a notation should be made in the chart listing the physician's concerns, but physicians should be careful when using diagnoses such as "drug-seeking behavior" without solid evidence. A listing or card file at the nurses' desk of "drug seekers" violates patient-physician confidentiality unless it is part of the patient's permanent medical record and subject to the same controls restricting access. Drug-seeking behaviors can be divided into two groups: "predictive" and "less predictive" of drug-seeking behavior (lable. , . 34-5). The behaviors listed under "predictive" are illegal in many states and form a solid basis to refuse narcotics to the patient. However, the possibility still exists that the patient could have pain and should be evaluated for a medical or surgical illness and possibly treated with a nonnarcotic drug.

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Dieting Dilemma and Skinny Solutions

Dieting Dilemma and Skinny Solutions

The captivating thing about diets is that you don't get what is researched or predicted or calculated but rather, you get precisely what you expect. If the diet resonates with you then it will likely work, if it doesn't resonate, it won't.

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