It depends on the hospital system, and what systems they use, nowadays with technology and all when you are being Triaged in the ER by the triage nurse they will be asking you symptoms typing their shit in their computer and some will ask you if you are still so and so medications, which leads me to believe that some hospitals have the technology where the triage nurse can see all scripted meds you're currently on. The advice given above to just deal with withdrawal isn't bad advice but if you are currently in legitimate pain and you have insurance and a co pay of $150 or whatever your copay is for an ER visit, then go ahead and go to the ER and be upfront and hope you get a sympathetic Nurse/Doctor, it all depends on the nurse or doc, some times in the past I've been completely shut down for help with narcotic pain meds due to them knowing my past addiction, and other times while telling the nurse that I am a recovering addict and I know I it can be a touchy subject but that I am in pain and am requesting something for pain it doesn't have to be a narcotic, and the awesome nurse said right after what I just said, said to me "I can give you a shot of Dilaudid"? Of course I greatfully obliged!