Don't let the door hit your a** on the way out, pal

The only thing that keeps prescription drug addicts out of my ER are "pain" clinics* and street dealers, but the ER and clinics are cheaper than drug dealers since drug dealers don't take Medicaid. Financially-wise drug addicts will overwhelmingly choose the ER or the "pain" clinic and their $1 Medicaid co-pays over Joe-Joe on the street who charges $7 per pill.

Pain clinics try to stifle a lot of this drug-seeking and drug-abusing behavior by making patients sign a pain contract which says they will submit to random drug tests and being the patient's ONLY source for controlled-substances for pain or "pain". If the drug tests are positive for things they didn't prescribe or if the patient is found to be obtaining additional prescriptions for controlled substances elsewhere, they are often kicked out of the pain clinic's practice. No big deal to the pain doc because their waiting list to be see is often months long.

Here's a pain clinic patient that you will likely find enjoyable to read about. Not.

* = Many people that go are in real pain and are willing to try anything, narcotic or non-narcotic, many others use them as their drug dealers

Hat-tip to KevinMD.