Opioid Prescription for Chronic Pain Leads to Addiction

Case Overview

This case study involved an adult patient with a medical history of degenerative disc disease, carpal tunnel syndrome, and osteoarthritis. The individual was managed on opioids for chronic pain relief.

The patient began treatment under a newly hired family medicine physician who significantly increased his opioid dosage, and the number of pills prescribed, and permitted early refills of opioid prescriptions.

As a result, the patient developed an addiction to opioids, necessitating inpatient rehabilitation. This case explores the standard of care provided by family medicine physicians.

Questions to the expert and their responses

How often do you evaluate and manage chronic pain patients?

As a board-certified family medicine practitioner and associate professor of family medicine, I frequently care for patients suffering from chronic pain. My approach to managing such cases is multifaceted and prioritizes safe management strategies.

What are the most pertinent clinical considerations when prescribing opioids for chronic pain treatment?

When developing a pain management strategy, it’s crucial to utilize all available resources. In this particular case, orthopedic specialists, potential pain specialists, cognitive-behavioral therapists (CBT), among others could have been consulted to reduce reliance on opioids.

Opioids should only be used for severe pain, at the lowest effective dose possible. It’s also important to have a signed pain contract in place and implement safety measures to prevent overdose or overuse.

Special considerations need to be made for patients who use other substances or have a history of substance abuse.

Have you reviewed a case similar to above? If so, please briefly describe.

I have encountered numerous cases involving improper opioid prescription practices leading to addiction issues. Each case underscores the importance of a comprehensive, multidisciplinary approach to pain management.

About the expert

This expert is a seasoned professional in the field of family medicine with over a decade of experience. They are board-certified in both family and obesity medicine, demonstrating their comprehensive knowledge in managing complex health conditions. Currently serving as an associate professor of family medicine at a renowned university and an attending physician at two affiliated hospitals, this expert brings significant academic and practical insights to the case study on opioid prescription practices for chronic pain management.