Woman looking at many obstacles on the road to personal health

Not Drug-Seeking. Relief-Seeking: Feeling Judged When Seeking Medical Care

Most of us have experienced it: being treated as a drug seeker when pursuing treatment for migraine. Whether it be when searching for a new doctor, going to the emergency department for an intractable attack, or when getting a prescription filled, many migraineurs have experienced some sense of being accused of being a drug addict feeding a habit when all we want is relief from pain.

The emergency department is no place for migraine

I think we can agree that the emergency department is no place for someone experiencing a migraine attack. The bright and fluorescent lighting, loud beeping of monitors, screaming babies, and an interminably long wait make it truly is the last place anyone with an actual migraine attack would choose to go. We only voluntarily expose ourselves to this kind of painful sensory overload when an excruciating migraine attack leaves us completely out of options. We go to the emergency department only when we’re exhausted, dehydrated, and desperate, and when nothing in our personal arsenal has worked.

Being treated with suspicion

While I appreciate vigilance in the face of the current opioid crisis, I wish that emergency department staff could be educated about the plight of the migraineur to more fully appreciate this complex neurological disease. I know they are suspicious that we are drug-seekers, but I can only assume there are easier ways to score drugs than by faking extreme pain and vomiting, sitting for hours in a noisy, stinky, windowless space, paying an exorbitantly high hospital bill, with no guarantee of being given opioids or other narcotics.

Rather than being treated with compassion– like someone presenting with a visible condition such as broken bone, people with migraines are often greeted with a series of weighted questions. These questions are designed to test our claims of pain. We are asked about our treatment protocol both at home and in past visits to the emergency department. If our answer includes any opioids, we can feel the medical provider silently exclaiming, “ah-ha!” as s/he declares that this class of medications will not be employed in our case.

Lack of specialized training

Emergency department doctors have generalized knowledge in a wide array of areas but often lack in-depth training on specific medical conditions. For issues such as migraine, specialized physicians may be called in to consult. Unfortunately, there are a scant few migraine specialists in the world, so the emergency department physician often relies on neurologists for advice. However, general neurologists may lack specialized training in migraine, and may not have the latest treatment options in mind.

Further complicating matters is the fact that there is some disagreement within the community of migraine specialists and neurologists regarding the best course of action for prevention and treatment. This, most likely, due to the fact that there is a wide variety of migraine types and many kinds of treatment strategies available. Finally, few patients respond to the same medication in the same way.

The question of opioids

The use of opioids as part of a migraine treatment protocol is an especially hot topic that causes strong disagreement among migraine specialists for many reasons. Many believe the introduction of these medications into the patient can actually flip an irreversible switch transitioning episodic migraine to chronic migraine. Others believe wholeheartedly that, for a select few patients, this course of treatment has proven to be the only one that actually works.

Strategies to quiet the accusers

Here are some approaches to help quiet those who may overtly or subconsciously accuse you of seeking drugs:

  • First, create an established relationship with a migraine specialist. Though these doctors can be hard to find due to a current nationwide shortage, it’s worth seeking them out. They are the best trained to navigate the complex neurological disease that is migraine. A good migraine specialist will work with you to develop a strategy for how to handle a persistent migraine attack while avoiding the emergency department.
  • If you do have to go the emergency department, work with your doctor (even your general practitioner if you cannot find a specialist) to create a list of interventions that might work for you or have worked for you in the past. For particularly intractable migraines that require a visit to the emergency department, that may involve some kind of IV infusion of several medications. This will show the doctors and nurses that you are prepared, know your history and what you need. Have your doctor’s contact information and a list of all the medications you take on hand.
  • When doctors, pharmacists, friends, or others seem to be judging your medical plan, remind these people that you are under a doctor’s care, and your medical care is between you and your doctor.

What other ideas to you have to deal with feeling accused of seeking drugs instead of seeking relief? Share your experiences in the comment section below so we can learn from one another.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


View Comments (24)
  • carla-fisher
    6 days ago

    I have a written prescription for treatment from my migraine specialist that I keep in my purse at all times. I show it to the ER staff and they treat me the way my doc has outlined. I usually just need to be knocked out. They don’t question it. Or at least they don’t say anything to me if they do. I go to an Urgent Care facility instead of an ER. So far I have had very good care. The last time I went my Botox had worn off it usually only work 7-8 weeks for me I had had a migraine since dec 17 and it was January 12th the moron doctor told me I couldn’t possibly have a migraine that long, and that they only last no more than 8 hours. He said he had done a lot of research into it. I told him he needed to find a better place to do his research I told him to do his research through the national headache foundation and the migraine foundation not I’m a moron.com. I told him I’ve been dealing with migraines since before he was a twinkle in his mama’s eye.
    He gave me my prescribed regimen and a script for an antibiotic.

  • Holly Baddour moderator author
    2 days ago

    Sounds like you’re a very experienced migraineur! Thank you so much for sharing your regimen and how you are properly prepare for ER visits. It really can be a challenge and it sounds like with a combination of the right paperwork and self-advocacy, you are able to maneuver through the system quite well.

    Grateful to you for sharing this with the rest of us!

  • bluesguy
    6 days ago

    Hi Holly, and thank you so much for taking the time to write about such an important issue that most migraine sufferers deal with on a regular basis. I agree with an earlier comment, that there is a huge difference between addiction and tolerance. I am aware of the new war on (opioids), and I find it to be so sad, that so many good people who suffer with so much pain have now become victims of the new system. It is inhumane to treat people with such disrespect, when they are only trying to be free of severe pain.
    I would advise those who have been turned away by urgent cares and E/Rs to pursue a good pain specialist. Most pain specialists are open to prescribing appropriate pain medicines, and are detailed in there work. They will provide the patient with appropriate pain relief, collect urine screens on every visit to be certain that the their patients are taking the medicine, and not taking something that they have not prescribed. I think that having a good pain specialist in ones corner would help countless migraine sufferers. Thanks for another great article.

  • Holly Baddour moderator author
    6 days ago

    Hi there! Great to hear from you, as always, bluesguy. Thanks for the kind words. Yes- good to encourage others to seek out competent migraine/pain specialists to help maneuver through the current mess of our healthcare system in order to have the best chance of achieving a quality of life. Stay in touch!

  • StefD
    7 days ago

    You really want to feel judged as drug seeking, try going to a specialist for something and get the look as they review your medication list. On top of chronic migraine issues I have sever osteoarthritis. Screwed my knee up working out and needed to consult with an Orthopedist. I ended up “schooling” both the Med. Assistant and the doc about judging without knowing history or reasons. After 30 years of this I am so extremely tired so “schooling” supposed medical professionals that not everyone with opioid prescriptions is a drug seeking addict.

  • Holly Baddour moderator author
    6 days ago

    Thank you so much for chiming in on this. Yes! I’m sure many of us can relate to the reality you described of having to share the list of medications in various situations to various doctors/nurses and/or their physicians/nurses in training. The side-glances and ignorant questions exude judgement and put the onus on us to educate and explain to others what and why we are taking our medications. It is difficult not to feel as if we are made to justify our treatment approach when it is truly no one else’s business but that of us and our migraine specialist.

    Glad you shared and that you are a part of our community!

  • JPaula
    7 days ago

    This article couldn’t have come as a better time. I am currently feeling “strange” with both my primary care and neurologist (who is a headache specialist).

    I made the mistake about a month ago of asking for Tylenol 3. If all my other medications don’t make my migraine go away then I have found it helpful to take a Tylenol 3 and just sleep it away. And now I am being treated like all I want is drugs. They have decided to go in the direction of “preventative” drugs now rather than “abortive” drugs – and I am all for that – I’d love to prevent my migraines.

    Anyhow the first drug they tried last week was Metropolol and I have to say that it gave me bad migraines all night and finally today I said that I don’t want to take it anymore. So now I am in a funny place. My primary wanted me to continue and I said that I wouldn’t. I need to sleep and work and live my life.
    Does anyone have any suggestions of a “preventative” drug that helped them? I know that we’re all different. There are many things that trigger my migraines and they usually come at night – most nights.

    I am exploring the possibility that they are rebound headaches due to overuse of Advil and Excedrin so I am not taking those OTC drugs now (recent insight)…

    Any help or suggestions would be appreciated.


  • Holly Baddour moderator author
    6 days ago

    So sorry to hear that you now feel as though you’ve been flagged as a drug seeker for merely mentioning Tylenol 3. I understand that now you feel the dynamic has shifted such that if you want to get off a different medication, they think you are angling for an opioid. It’s great to educate yourself on various preventatives as there are many. You might review this list and bring it with you to your next appointment: https://migraine.com/migraine-treatment/prevention-medications/.

    Getting clear on your triggers can also help. You said that most of your triggers happen at night. https://migraine.com/living-migraine/detective-triggers/. Perhaps doing a bit of an inventory and gaining clarity of what is setting off your migraine attacks, in addition to bringing a list of potential preventative medications with you to your next appointment will help to shift the conversation with your specialist away from opioids to show them that you are wanting to be a proactive partner in your care, looking at the big picture.

    Thanks so much for sharing some of your story and please stay in touch!

  • pigen51
    7 days ago

    I used to get 30 Norco 10 pills per month, to use to try and keep my migraines under control. But I found myself having to use them up earlier and earlier in each month. I went to my next doctors appointment at told him, I think I have problems with narcotics, and may be addicted to them. I was not going to hide anything from him, I have a family history of addiction and that is a road I don’t want to go down.
    The problem is that I have had migraines for 40 years, and I have of course tried pretty much every single thing I could think of, and my doctor could toss at me. And after all of this, the only thing that has ever worked has been a narcotic and something for nausea.
    So now, because I have been honest, and told my doctor that I was concerned that I might be getting to dependent on opioids, I have found that my name is on ” the list”. I went to the Emergency Room a couple of weeks ago, with a kidney stone. They wanted to give me a shot of toradol. I cannot take that drug, due to a stomach issue, which causes extreme pain for several days later. So they instead gave me a shot of Benadryl and nothing else. I was not happy, but mostly I was amazed. Fortunately, I only had a small stone, which I passed at home a few days later. But I will eventually get a bigger one, and I just wonder what will happen when I present with the pain from a 7 or 8 millimeter kidney stone.
    I understand their thinking, of course. But the issue is, I self reported my concerns, thinking that my doctor would monitor my use of my Norco, perhaps asking me to bring them in a couple of times a month to count them to ensure I was not taking them too often, or such. The problem is, I am still get migraines nearly every day. I am on disability due to migraines. If I get 5 days a month with no migraine, I am lucky. I am not suicidal, I have too much to live for, but I do understand those who cannot bear the pain and give up.
    I am currently working with a new neurologist, on a trial with Aimovig. I have not experienced any results yet, but he told me that it could take 3 months or more, and it has only been a little over 2 months. So wish me luck. And please, don’t ever feel sorry for me. I have a wife who for 26 plus years has been the best thing that I could have hoped for, and I would never change anything.

  • Holly Baddour moderator author
    6 days ago

    My goodness, I’m sorry to hear of what sounds like an overreaction – to take a whole class of medications off the table for your future due to your honesty with your physician regarding a history of addiction in your family. I agree with the community member’s comment below pointing out the difference between addiction and tolerance. It’s an important delineation. For many, opioids provide the best pain management and give them the best chance at a quality of life. Therefore, the challenges related to building a tolerance are ones that have to be managed with ones physician- just like you offer (carefully managing and monitoring the amount of medications prescribed each month).

    As for Aimovig- yes- best of luck with that. We have a forum dedicated to that topic it in case you’d be interested:https://migraine.com/topic/tried-newly-approved-aimovig-share-experience/

    Glad you have such a supportive spouse and please know you are a part of a supportive and thriving community here at migraine.com. So glad you’re with us. Stay in touch!

  • SteveIndy
    7 days ago

    @pigen51 Sorry you have been treated that way. I too feel judged whenever I ask for a narcotic Rx, or fill it at the pharmacy. I wanted to clarify the difference between “addiction” and “tolerance”, as you mention both terms in your comment.
    Tolerance is almost inevitable if you take opioids on a chronic basis. It means the drug effect becomes lessened over time, and you may need a higher dose to get the same pain relief. You can develop tolerance without becoming addicted.
    Addiction on the other hand is a psychological condition where you feel compelled to take the drug even knowing it may be harmful, and taking the drug becomes a priority in your life over normal, healthy activities.
    I have developed tolerance of narcotics over the years, but without any sign of addiction. I can easily stop taking narcotics for 3-4 weeks, and I have done that, but it is harder to manage the migraines when I do that.

  • Holly Baddour moderator author
    6 days ago

    Grateful for your clarification on this incredibly important delineation of terms. People frequently use these words interchangeably or incorrectly and it can be a hurtful ignorance for those of us who are taking opioids responsibly. Thanks so much for taking the time to raise awareness on this front.

  • aderose
    1 week ago

    Thank you for this! It’s been almost 7 years since I have had to go to an ER for migraine, but I remember the feeling well.
    I have been under the care of an amazing neurologist/Headache specialist since 2012 and have changed from a daily beta blocker to a calcium channel blocker to help reduce the visual aura. I started a sleep aid a few years ago because apparently post menopausal women who don’t sleep well have more migraine days. I keep an RX of rescue meds (yes, they include opioids) and I have found that Advil PM sometimes works (something about Benadryl and migraine)
    I am about to try the new class of preventative migraine drug. I start with Emgality injections this week. I am aware that I am one of the lucky ones. I only have 6 to 10 migraine days a month. Hopefully this medication will reduce that number.

  • Holly Baddour moderator author
    6 days ago

    Thanks so much for sharing some of your story with us. Glad to hear you have a good relationship with your migraine specialist.

    Would be interested to hear about your experience with Emgality. We have a forum dedicated to this topic here that might be of interest to you: https://migraine.com/topic/emgality-share-experience/

    Stay in touch!

  • Holly H.
    1 week ago

    I have chronic/constant migraine with aura for 10+ years and about 2 or so years ago quit going to the ER as well for migraine. The first of the last two times, one side of my face was obviously pulling down severely, and it just plain scared me. And they still started the suspicions song-and-dance. I told them to look in my records – that I had never asked for pain medication – just needed checked out for stroke or something. The second time when the one side of my face had no feeling, the doctor told me that he looked even before he came into the room because I was there for “migraine,” and saw that I had never asked for pain medication. (No judgment here – I have many big-time allergies and untenable side effects to most everything, and they just don’t work more than the allergies/side effects are worth.)
    So, neither time did I ask for pain meds and also told them I did not want any because of the allergies and side effects… and still I was treated the same as y’all. It sure seems a no-win situation if the word “migraine” is used.

    Oh, and that second time? They took care of everyone else in my section of 10 beds, and an hour and a half after all treatment was done to work to bring back feeling to my face and that I was to be discharged, the nurse said that she “went ahead and took care of all the sick people first because, after all, I was just there for a migraine.” The feeling in my face was pretty much back, but the migraine had gone nuclear by the time this “patient with just a migraine” was discharged.

  • Holly Baddour moderator author
    6 days ago

    Oooo, that IS infuriating to be dropped to the bottom of the list of those to be tended to because of having “only” a migraine. While it’s true that most often a migraine on its own is not an emergency, you bring up a good point that migraineurs often go the the emergency room when we are having unusual and troubling symptoms that are out of our ordinary migraine experience to ensure that we are not dealing with something more serious.

    Thanks for sharing.

  • ladymet117
    1 week ago

    Hi Holly. A quick question. I want to tell my story about my journey with migraines. I see that you are a moderator. Do I have to go through you before I write my story? I read the community rules. New here, just joined yesterday.

  • Joanna Bodner moderator
    1 week ago

    Welcome to our community @ladymet117! We are so happy that you found us! I sure hope you find the support & information you are looking for. We would LOVE for you to share your personal migraine story with us. You can do so via this link here. We look forward hearing & learning more about your journey with migraine.

    Please reach out anytime for support or with any questions you may have!

  • ladymet117
    1 week ago

    Hi Holly. I feel you! I try to stay away out of the ER if I can. Because of the drug seekers, they have made it soo bad for the people who really need the narcotics for the pain that they are having! When I go to the ER, I show up wearing “Ray Charles” shades & I have ear plugs in! And it’s late at night! The doctor wants to give me DHE or one of its relatives. I don’t like DHE, I don’t want it, but I’m hurting soo bad I can’t argue w/him. I tell him that I don’t want a prescription for pain medicine because I have medicine at home ( under a pain medicine contract). I feel worse than I did before I came there! And get this, I’m a nurse! Been a nurse since 1985! I have a wonderful pain management doctor and neurologist but getting in takes a few days. But I have meds at home as well as other things that I do to help me stay out of the ER! I hope and pray that you are working with your doctor so that you can have other things onboard to help you get through the migraines so you don’t have to go to the ER! But if you do, get you a pair of dark shades and some ear plugs! They do help! And don’t worry about what people say or think about you! You’re in excruciating pain and need help! Good luck! I UNDERSTAND!!!

  • Holly Baddour moderator author
    1 week ago

    Thank you for your kind note. And yes, thankfully, I am working with a great migraine specialist. It’s been years since I, personally, have had to go to the ER, but I have been there more times than I can count and I’ve definitely been traumatized by the experience. It’s important, as you say, to have a back up plan with your doctor to do all you can to stay out of the ER- however, there are times that it’s unavoidable. Creating a plan of action (including sunglasses and earplugs) in case it occurs is a smart idea, for sure.

    Thanks for chiming in! So glad you’re a part of our community.

  • Kate
    2 weeks ago

    I avoid the ER and urgent care and such at all costs, as they have never helped. Thankfully my primary care doctor can often do same-day appointments (although that is limited to office hours), so I’ve done that a few times for acute migraine, but they aren’t set up for IVs or anything, so its usually just getting a steroid rx and considering changing up my preventative and/or abortive meds.

    My neuro has a 2-3+ month wait for appointments and can’t support any acute help. Therefore it mostly comes down to trying to prevent migraines and having as many abortive treatment options at home as I can. I wish there was a headache clinic with an on-demand IV center I could get into. I’ve never even been able to try any IV meds.

    I’m one of the few on daily opioids (for NDPH, constant headache which is constant from the start), as I’ve trialed and failed everything we’ve thrown at it for over a decade and 3 doctors agreed it was a good option for me. However, I definitely see judgement when I see practitioners other than my usual supportive docs. Some have even told me I need to get off of them when I am seeing them for the first time for something completely unrelated and they don’t know my history. I’m fearful for the future as I think its a matter of when not if they will cut off all pain patients. Its already a problem for many pain patients whose pain clinic has closed, their primary doc won’t prescribe and they can’t find a local pain doc, etc. I’m one of the lucky ones as my clinic is now one of the few in my area.

    I can definitely see the importance of trying to limit opioids for episodic headache/migraine, but for severe chronic pain, there are some folks like me who need opioids as part of their treatment plan to have any semblance of quality of life, as the longevity of the pain really wears on a person.

  • Holly Baddour moderator author
    1 week ago

    Thank you for speaking to the reality of living with daily chronic pain and your use of opioids to manage that condition. It does feel like a vulnerable time for those of us, like you, who are utilizing these medications to manage our pain so that we can have some semblance of a quality of life, as you so aptly state. Grateful for your input.

  • Daisy910
    2 weeks ago

    It’s the same with me. I’ve had a constant, intractable headache for 47 years. Going to the ER is ridiculous, getting treated like I REALLY want to spend $2000 for a 4-hour “high.” My doctor used to get me in for a shot of Demerol or Dilaudid the same day, but now with all these opioid-addicted morons screwing it up, no doctors will give injections anymore. It’s a sad state of affairs when people in real pain get treated like crap because other people can’t play by the rules.

  • Holly Baddour moderator author
    1 week ago

    So true! Incredibly frustrating to have a whole class of drugs be closed off from people living with chronic pain due to the misuse of others. A broad brush stroke by the government when one would think they could find a more careful and refined way to handle the challenge of opioid addiction. Thanks for your comment.

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