How do you deal with those pain sesking patients?

I have this 20 year old male on dialysis secondary to uncontrolled diabetes who came in with intractable abdominal pain nausea and vomiting.Dont get me wrong hes not on any chronic opiod regimen so dont want to jump to conclusions but his pain is 20/10 getting fentanyl 25 q3 hrs. Ct abdomen completely normal. Egd normal. BP normal, Labs nml Tried reglan for concern for gastroparesis yet nothing. Tried to wean this guy off fentanyl and his mom throws a tantrum that he is in so much pain. No... How do you deal with those pain sesking patients?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Internal Medicine and IM Subspecialties Source Type: forums