Dr. Sellers calls Mrs. Wright's outpatient pain physician, Dr. Smith to let him know about the changes made to her home opioid medication regime.
Dr. Sellers tells Dr. Smith about the increase in opioid pain medication for Mrs. Wright due to her ankle fracture and subsequent surgery. She relays Mrs. Wright's concern about taking opioids and benzodiazepines at the same time. Finally, Dr. Sellers tells Dr. Smith that Mrs. Wright may want to speak with him about her concerns and ask about other modalities she may be able to treat her pain and anxiety.
Dr. Sellers lets Dr. Smith know she's given Mrs. Wright some resources for reference and has let her know to contact Dr. Smith to speak with him personally.
Dr. Smith says he'll make a note in Mrs. Wright's chart to discuss her concerns with her when she comes to see him next month.
CDC Recommendations
The CDC recommends that doctors and patients discuss utility of opioids to treat short term pain versus chronic pain, noting that there is less evidence to support benefit in the long term.
Non opioid treatments should be considered such as:
- Physical therapy
- Non-opioid medications
- Cognitive behavioral therapy
Precautions should be taken, such as:
- Checking drug treatment databases (PDMP)
- Urine drug test
- Offering Naloxone if indicated
- Methods to protect a patient's family or friends by safely storing or disposing of opioids.
Check patient fact sheet for safe and effective pain management.
Test Your Knowledge
Question 1
Which of the following are COMMON risks of opioid pain medications, especially when used concurrently with benzodiazepines? (Chose all that apply.)
Question 2
Which of the following is the most concerning medication in a patient who is taking opioids?
Question 3
Why would you use the PDMP?
Question 4
At which dose or OME would you consider offering Naloxone?
