"Even When Patients Describe Pain in Vivid Detail, Doctors Have Few Tools to Determine What's Real."

How is a doctor supposed to tell who's for real and who's a drug abuser/reseller?

"Sometimes it's the patients with elegant clothes and three kids who call a week after a filling and say they need pain medication. That's when my radar goes up," says George Kivowitz, a dentist in New York City and Newtown, Pa. Insisting that the patient come in to be re-examined usually ends the conversation, he says....

"I always ask a patient, 'How are we going to show that this intervention has helped?' " says Scott Fishman, president of the American Pain Foundation who wrote a widely used guide to responsible opioid prescribing. "The person who is just trying to get opioids will say, 'Ah, later, dude' and go somewhere else."

Sometimes it's a guy in a 3-piece suit and sometimes it's guy who says "dude."