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Assessing suspected substance abusers

Staff Development Weekly: Insight on Evidence-Based Practice in Education, May 3, 2007

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A patient who presents to the ED with a substance abuse problem is not likely to discuss his or her addiction openly with you. During your assessment of the patient, he or she could be intoxicated, in acute withdrawal, or in no apparent distress at all. Look for the following signs and symptoms to help better identify these patients:

• Needle marks. These marks can be on any part of the body, but typically on the arms. Also be aware of patients who have abscesses or infections as a result of using dirty needles.
  
• Erratic behavior. When you entered the room, did the patient quickly move from watching television to lying in bed, moaning and groaning? Was he or she in pain one moment, and then asked to go smoke a cigarette the next?
  
• Tweaking. Especially common for patients who abuse methamphetamine, "tweaking" is the way health professionals describe a patient's difficulty focusing, dilated pupils, and jerky body movements.

Editor's note: The above excerpt is from the online course "Handling Difficult Patients: A Guide for Healthcare Staff." For more information on this and other courses in our library, go to http://www.hcprofessor.com.

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