Patients often lie about drug use and that can interfere with care. Part of practicing emergency medicine is using skill in communication to get through those communication pitfalls.
To get patients to tell the truth on drug use, start with asking about past use. Then ask current.
Furthermore, sometimes it helps to ask the question specifically In my area, I tend not to ask “do you use drugs?” I ask “did you try amphetamines when you were younger?”
If they answer affirmatively then can expand to “when was the last time?”
If you have doubts about their answer, you can say “may I test your urine and confirm?” Their response is often revealing.
TAKE HOME POINTS
-Ask about past drug use first
-Then ask about recent drug use
-Ask permission for a drug screen