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For core clinical content designed to help you safely and effectively manage patients with chronic pain, when appropriate, with opioid analgesics, please visit our sister site, SCOPE of Pain.

 

  1. Massachusetts Laws
  2. Educational Program Making Sense of Massachusetts Opioid Prescribing Laws and State and National Guidelines Program CME Post-Test Evaluation
  1. Dental Pain
  2. Educational Program Safe Opioid Prescribing for
    Acute Dental Pain
    Program CME Post-Test Evaluation
  1. Prescribe to Prevent
  2. Educational Program Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists Information Program CME Post-Test Evaluation
  1. Military Modules
  2. Module 1 Military SCOPE of Pain: Safe and Competent Opioid Prescribing For Providers Working with Veterans and Military Service Personnel Information Video CME Post-Test Evaluation
  3. Module 2 Military SCOPE of Pain: Safe and Competent Opioid Prescribing For Providers Working with Veterans and Military Service Personnel Information Video CME Post-Test Evaluation
  1. Video Modules
  2. Module 1 Case Studies In Practice: Applying Principles
    of Safe Opioid Prescribing
    Information Introduction Cases Case I Case II Case III Certification CME Post-Test Evaluation
  3. Module 2 Complex Convrs. High Dose Opioids
    & Illicit Drug Use
    Information Introduction Cases Case I-A Case I-B Case II Certification CME Post-Test Evaluation
  4. Module 3 Using the PDMP PMP Questionable Activity Information Introduction Cases Case I Case II Certification CME Post-Test Evaluation

Case II: Illicit Drug Use, Established Patient Case II: Illicit Drug Use, Established Patient

Mr. Paul Russo is a 48 year old male, established patient, who presents for follow-up who has had chronic right knee and ankle pain for the past 5 years after a motorcycle accident. He is on hydrocodone 5 mg with acetaminophen 500 mg 2 tablets 3 times per day for the past 3 years.

On routine urine drug testing his most recent urine is positive for hydrocodone and cocaine.

Pain history:
Posttraumatic knee pain status post infected distal femoral and ankle fracture 5 years ago. He has been on opioids and NSAIDs ever since.

His pain is always 4-5 out 10.

Other medical history:
none

Substance use history:
History of marijuana use 10+ years ago. He denies current use. No family history of substance abuse.

Social history:
He lives with his long-term girlfriend. He is employed at a friend’s store as a cashier where he is able to sit most of the day.

Physical exam:
Uncomfortable with ambulation. He uses a cane. His knee is deformed with very limited range of movement.

Will you continue to prescribe hydrocodone in the setting of cocaine use?