Table 2.

Signs that may suggest opioid inappropriate use and alternate explanations in cancer patients (Gourlay et al., 2005).

Sign	Alternate explanation(s)
Unkempt appearance	Patient may be depressed or overwhelmed by illness; patient may have symptoms related to cancer treatments that cause them to feel sick all of the time and thus neglect their appearance
Anxiety, nervousness, agitation	Patient may be upset about cancer, his or her prognosis, or have fears relating to treatment, home or hospital care, or financial worries
Sniffles	Allergies, cold, sinus problems, symptoms associated with cancer treatments
Watery eyes	Allergies, cold; symptoms associated with stress or fear
Cough	Cancer-related cough; allergies, cold, heart burn
Lethargy	Fatigue, depression, disease progression, lethargy related to treatments, especially chemotherapy, lethargy associated with other drugs the patient might be taking
Drowsiness, nodding off	Fatigue, disease progression, adverse effect related to treatment especially chemotherapy or other drug therapy
Skin lesions (from injecting drug)	Possibly related to other drug therapies associated with the cancer; skin disorders, rash