The irony is the timing, because I essentially said the same thing this week while working (parts, at least). As I told the staff, "these people think they are so sly and so brilliant, but I am smarter than they are". One of the nurses said that "someone is always smarter than you", and my response was "but none of them are in any of these beds!"
I say, repetitively, "don't lie to me". The last vagrant I gave money to? A dude that says, "I'm drunk, but not drunk enough." I gave him a couple bucks for being honest with me.
I will give patients a shot in the ED, but no Rx to go. Moreover, some people should be careful for what they wish for, as they may get it (as I interpret it). 5mg oxycodone x #5 - is that worth your wait? Also, when I tell you that, if your headache responds to Dilaudid or "that drug that starts with "d" and end in "emerol", but I can't remember the name" (again, I'm not that stupid), that it's not a migraine, that's a hint. An even bigger hint is when I tell you that I am not giving you any Dilaudid or Demerol (and you may even get the MPTP story from the 1980s, in less than a minute).
Where I'm at now, Lortab is Rx'd like candy - I had a streak of 10 patients in a row last weekend that all were chronically on Lortab, prescribed by their doctors. I don't Rx Lortab (well, one guy who was just dumb got 5 to cover him over the weekend, as I was in the next day, and didn't want this guy to be puking and having diarrhea, and being a pain in MY butt).