Narcotic-Seeking Behavior and Self-Injury: A Report of Three Cases

Patients addicted to prescription opiates have found innovative ways to reliably obtain their desired prescription opiates at a time when such prescriptions are restricted due to the opioid crisis. Instead of turning to the black market, some patients deceive their health care providers and malinger to create or enhance severe chronic pain conditions that require medically necessary treatment with prescription opiates. Such sophisticated narcotic-seeking patients set up situations by which they become severely and chronically injured through natural or iatrogenic means. This article reports 3 cases of narcotic seeking manifested through deceptive self-injury behavior that were underwritten for life expectancies in legal matters. Underwriting mortality risk requires different authority, resources, and anti-fraud skills than what is typically available to health care providers. Using such authority, resources, and anti-fraud skills, life underwriters can identify deception, malingering, and sophisticated narcotic-seeking behavior that health care providers typically do not or cannot explicitly acknowledge.