Mutual Matters

Case Studies: Pain Management with Opioids

Posted by Bill Kanich, MD on Jan 19, 2017 1:00:00 PM

prescription pad, writing prescription

Case Study #1

A 34-year-old male presented to a family medicine physician for chronic low back pain. The physician is comfortable prescribing opioids and has many patients on scheduled drugs. The patient has had chronic pain for many years and undergone multiple treatments including physical therapy, steroid injections and many medications. On presentation, the patient was on Robaxin and oxycodone (four times a day). His past history is positive for hypertension and alcohol abuse, although he stated he hasn’t drank in the past year. He works as a laborer.

On exam, the patient is in moderate distress with his back pain. His BP is elevated at 160/100. Low back and neurologic exam are normal. The physician institutes OxyContin 10 mg BID for pain control and Clonazepam for muscle spasm. On a follow-up visit two weeks later, the OxyContin is increased to 20 BID.

Two days after that visit, the patient picks up his medication at a local pharmacy. The next morning, the patient is found unarousable by his roommate and declared dead at the scene by paramedics. The cause of his death is polysubstance drug overdose with evidence of oxycodone, benzodiazepines and alcohol on his toxicology screen. A lawsuit is filed against the physician.

Discover a second case study on pain management, our case anaylsis and our patient safety discussion below. 

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