259 Case Series of Deceptive and Intentional Self-Burning for Narcotics: A Hidden Problem within the Opioid Epidemic

Abstract Introduction Self-inflicted burns (SIB) as a means to suicide or self-harm account for 1–2% of all burns annually in the US. We have observed a subset of patients at our institution, where SIB is motivated to receive opioids. This group is not forthcoming about how their burn occurred and go to great lengths to deceive medical providers while also displaying drug-seeking behaviors. Though only a small percentage of our burn patients, the number of patients and burn incidents per patient is increasing. This, combined with the challenges involved in managing and caring for the deceptive SIB patient, highlightsthe need for further investigation, particularly in light of the opioid epidemic. This study aims to characterize patients with repeated SIB who intentionally deceive medical providers to obtain opioids. Methods We queried the burn registry and electronic medical record (EMR) to identify all adult burn patients evaluated at the Burn Center from 2005–2018 with 3 or more distinct burn injuries, evidence of SIB, and deception of medical providers, motivated by the desire for opioids. Clinical and demographic data was collected and analyzed. Results Fifteen patients met inclusion criteria. Patients were white males, aged 20–40 years old, with comorbid chronic pain, psychiatric and substance use diagnoses. Burns were