Howard is a 24 year-old male who presents to the clinic with his wife for what he states is severe lower back pain. He states the pain is so bad that he rates it as a “50 out of 10.” He also tells you that due to a past medical history of an ulcer, he cannot take any medications “like Motrin.” He states that the pain is from a car accident in 2012, and that it flairs up and he needs pain medications. He also tells you that he has a high pain tolerance, and that when he gets pain meds he requires the higher doses.

Discussion 1

1. What would you do first prior to prescribing any medication?
2. What are the various schedules of medications for controlled substances?
3. Would you prescribe a long or short acting narcotic? Why or why not?

Discussion 2

1. What other non narcotic medication options can you offer to this patient?
2. What patient education is needed with them?
3. What would you do if the patient and his wife tell you that none of them work for him?