All of the following are recognised warning signs of opioid-seeking behaviour EXCEPT:

Correct answer: D. Attending appointments in person as scheduled

• A. MISSING FOLLOW-UP is a genuine red flag. It suggests the patient's goal was the prescription rather than the definitive care, since a patient in real pain returns to have the cause treated.
• B. Requesting a SPECIFIC drug by name — particularly a short-acting, high-potency agent — is a recognised warning sign, especially when accompanied by a claimed allergy or intolerance to every non-opioid alternative.
• C. Unusual FAMILIARITY with formulations, strengths and dosing intervals suggests prior extensive use and is included in standard screening lists.
• D. CORRECT — this is the EXCEPTION. Presenting in person for scheduled appointments is NORMAL, appropriate patient behaviour. It is in fact the opposite of the classic pattern, in which the patient seeks the prescription while avoiding the examination, treatment and follow-up that would resolve the underlying problem.

Note: Other documented signs: reporting lost or stolen prescriptions, obtaining opioids from multiple prescribers ('doctor shopping'), requesting early refills, and resisting diagnostic workup. Check the state prescription drug monitoring programme rather than relying on impressions — and remember that undertreated pain in a genuinely suffering patient can mimic several of these behaviours.