A 32-Year-Old Woman Comes to the Emergency Department Requesting Medication

A 32-year-old woman comes to the emergency department requesting medication for severe back pain.  She has tried multiple over-the-counter agents and says that nothing has relieved her pain except oxycodone.  The patient was seen in a pain clinic a year ago but cannot recall the name of the physician and says that her prescription has run out.  Medical history includes a motor vehicle collision 10 years earlier and obesity.  Temperature is 37.1 C (98.8 F) , blood pressure is 130/80 mm Hg, pulse is 76/min, and respirations are 16/min.  Physical examination shows no abnormalities.  A recent MRI was normal.  The patient says that her pain level is 10 on a scale of 0-10 and becomes frustrated when the physician suggests nonprescription pain medication.  Which of the following is the most appropriate next step by the physician?

A) Challenge the patient about her drug-seeking behavior
B) Obtain confirmation of the patient's prescription history
C) Order a repeat MRI of the spine
D) Prescribe a 1-week supply of oxycodone
E) Refer patient to a substance abuse rehabilitation program
F) Refuse to prescribe opioid medication and recommend nonpharmacologic pain management

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free