One Way to Cure a Drug Seeker’s Back Pain

A gentleman in his 40s limped into the emergency department for evaluation of severe back pain. He had a chronic history of back pain, but had decided to forgo recommended surgeries because he was told that there was a chance his pain could worsen. He reportedly had multiple MRIs in the past … all of which showed “severely” bulging discs. He also just moved to the area the evening prior to his visit. In all of the excitement and heavy lifting, he strained his back, he couldn’t find his pain medications, AND he lost his wallet. That meant he had no ID and he couldn’t remember his address because, of course, he just moved into his apartment last night. He was in excruciating pain and couldn’t move without pain shooting to his legs. Oh, and his heart stopped after taking aspirin a long time ago and he was specifically told NEVER to take NSAIDs because they could kill him. His exam didn’t show too much except that he was in a lot of pain. So we ordered a muscle relaxant and a couple of Tylenol with codeine tablets. After about 15 minutes, he stated that the Tylenol #3 “took the edge off.” He got a shot of Decadron and we prepared to discharge him. He requested a couple of days of Norco pills until he could find his other prescription amongst all of the moving stuff. I gave him the benefit of the doubt and wrote him a prescription for a couple of days worth of Norco and Robaxin. However, I wrote on the prescription “DO NO...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Authors: Tags: Patient Encounters Source Type: blogs