Case I: PDMP Questionable Activity, Established Patient
Sarah Taylor is a 51 year old female, established patient, who presents for routine follow up with a new complaint of “heart burn”. She has chronic back pain after two surgeries for disc disease. She has been on stable dose of acetaminophen with codeine one tablet 3 times per day for the past 2 years.
Upon review of the state PDMP data, the patient has received prescriptions for oxycodone from 2 different prescribers in the past month.
She had a slipped disc when she was gymnast in high school. She required surgery. She had repeat back surgery 10 years ago when she slipped on some ice and re-injured her back. Her pain is usually 5 out of 10. She has excellent functional capacity working part-time and caring for her 2 children.
Other medical history:
History of a hysterectomy for fibroids and uterine bleeding.
Substance use history:
She quit smoking 5 years ago. She drinks on weekends. No drug use. No family history of substance abuse.
She lives with her husband, 2 children (ages 13 and 15) and works as a librarian in her children’s school.
She looks well with a completely normal exam.
Will you continue to prescribe acetaminophen with codeine in this patient with questionable activity on the Prescription Drug Monitoring Program?