Think twice before tapering opioids in some patients
Bill is a 58-year-old male with a history of head and neck cancer as well as chronic low back pain who presents to his new primary care doctor for a routine checkup and visit for a medication refill. He works in construction and has been on chronic opioid therapy after his cancer — with a stable dose of 15 mg of oxycodone for over five years.
At his new primary care visit, after a few meet and greet pleasantries, his new primary care doctor discusses his current medication regimen with him — ibuprofen 400mg TID and oxycodone 15mg BID. His physician expresses significant concern with his medication regimen, telling Bill that “it’s against the rules” to continue prescribing opioids for him — despite the fact that he’s been on this dose for several years.
She prescribes an oxycodone taper for him and requests he return to her office in two weeks for a re-evaluation.
Bill, not wanting to be a problem, takes his taper as prescribed for the first few days. However, as he’s been on opioids for over five years, he begins feeling sick — nausea, vomiting, malaise, and irritability. He tries to go back to his old dose but runs out of oxycodone. While trying to work at a construction site, Bill is having trouble completing his tasks and drops a few expensive objects.
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Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/casey-grover-and-lee-goldman" rel="tag" > Casey Grover, MD and Lee Goldman, MD < /a > Tags: Conditions Oncology/Hematology Source Type: blogs
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