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May 1, 2024

A 65-year-old female presents to the clinic to seek a repeat prescription for her pain medication. She had a motor vehicle collision

A 65-year-old female presents to the clinic to seek a repeat prescription for her pain medication. She had a motor vehicle collision (MVC) 8 months ago that left her with chronic neuralgia in bilateral arms along with lower back pain. She was prescribed oxycodone/acetaminophen 7.5/325 mg q6 hours. Her last scheduled refill was 20 days ago with a 30-day supply. She returns early, claiming she needed multiple dosages sooner than directed due to unmanaged pain. Her current vital signs are normal, but she is diaphoretic, tearing, restless, and occasionally yawning. When the provider explains, controlled medications cannot be prescribed in this manner, the patient states, “You don’t understand. I need to feel normal. Without it, I feel worse than I used to feel at baseline. Please!” In what stage of addiction is the patient, and what medication can be used to help her symptoms?

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