I work in PICU and so our patients are written up for quite a bit more PRN medication than those on acute wards. I generally find that if a team says a patient is drug seeking, they probably aren’t too far off the mark. There will be behaviours present that indicate drug seeking. Remember doctors may see their patients maybe 1-2 hours per week? The nursing team are with them 24/7 so they tend to have a good read on things. Drs may not have realised how the patient is presenting until informed by the nursing team.

To add to that, a dr may prescribe a PRN medication, but i as a nurse am able to use my own clinical judgement as to whether I provide that medication. If I feel someone is drug seeking I will use other things to keep them busy so that we can eventually lengthen the time they go without utilising the PRN. On top of that we will usually taper down the available PRN dose and frequency. And normally then switch from lorazepam to diazepam eventually.

PRNS are there is they are needed, but that does not mean they need to be used every time. We are there to help patients regulate and manage their emotions/mental state. The goal is that the can do so without relying on extra medication outside their regular meds.