How Do You Recognize Opiate Addiction in the Rehabilitation Patient?

Abstract

Robert Jones, a 42-year-old male, has been under medical management for chronic low back pain (CLBP) for the past 9 months. His rehabilitation program consists of weekly physiotherapy treatments along with medication therapies including a nonsteroidal anti-inflammatory drug (NSAID) and prescription opioid. Robert has missed his last three rehabilitation therapy sessions, and he presents to the clinic today with no appointment demanding to be seen by the nurse practitioner for an escalation in CLBP symptoms.When questioned about his missed rehabilitation therapy appointments, his anxious demeanor quickly demonstrates irritability. He states, "The only thing that helps my pain is the Percocet pills. The rehab and ibuprofen are a waste of time." He adds, "My family doctor doesn't know how to treat my pain so I need you to refill my Percocet prescription."

Factors influencing nurses’ knowledge and attitudes toward patients in chronic pain with opioid use disorder: A literature review

“…These behaviors include multiple late or missed appointments, forging prescriptions, reporting lost prescriptions, resisting changes in medication therapy, and reporting allergies or ineffective pain relief to any non-opioid analgesics, stealing or borrowing medication from others and seeking medications from different health care professionals. [12] Ashley(2008) [13] also reported on patients' behaviors of opioid abuse including running out of medication before follow-up appointments, self-adjusting medication dosing, aggressively demanding more drugs, and suggesting medication options to the health care provider. Other behaviors indicative of opioid abuse include refusal of physical examination, doing diagnostic tests, and providing medical history, or providing unclear medical histories.…”

Discharge Planning – A Priority in the Care Delivery Process

“…In her article, she identifies that 50% of stroke survivors experience AEs, many unexpected, and emphasizes the importance of education before discharge to prevent and/or immediately address these events (e.g., recurrent strokes, transient ischemic strokes, falls etc.). Gregg and Jones (), meanwhile, provides guidance regarding how to recognize opiate addiction in rehabilitation patients and actions that are appropriate while hospitalized as well as after discharge.…”