Mr Turner

Mr. Turner, a 42-year-old runner, had back pain and underwent surgery. He has been taking oxycodone for pain control and is requesting a prescription refill. A urine drug screen shows positive results for two substances. Mr. Brute, a retired NFL player, had a serious injury and was taking oxycodone for pain. He became scared after a teammate died from an overdose and stopped taking his medication abruptly, leading to withdrawal symptoms. He now wants to be weaned off the medication. Part 1. Mr. Turner is a 42-year-old avid runner, saw his neurosurgeon for chronic back pain that radiated to his right leg. After several non-surgical therapies, including the use of hydrocodone, Mr. Turner underwent an L4 and L5 laminectomy. He has been followed closely and has been prescribed pain medication and physical therapy. Today, he presents to you for a prescription refill. He is currently seven months post-op and he has started slowly incorporating walking and running back into his life. He states traffic has become increasingly more congestive and is a hassle to drive to his neurosurgeon's office. He reports he has had pretty good pain control with his current prescription of 20 milligrams of extended-release oxycodone three times per day, number 90. He says he is compliant with his medications and continues physical therapy two times per week. He will run out of his prescription very soon and would like you to refill his prescription. You verify the prescription in the monitoring program database and see he at last had the prescription filled three weeks ago. As per your office policy, Mr. Turner undergoes a urine drug screen. The results are positive for delta-9 and hydromorphone. Part 2. Mr. Brute is a 32-year-old retired NFL player. Five years ago, a collision left him with a patellar fracture and a torn ACL, ending his career. Post-operatively, he struggled with pain control, which was eventually achieved by taking 30 milligrams of oxycodone twice a day. A former teammate who also had a severe injury and struggled to control his chronic pain was found lifeless in his car. The cause of death was listed as an overdose. After attending the funeral, Mr. Brute became fearful of his oxycodone prescription. Without consulting a health care provider, he abruptly stopped taking his prescribed dose and suffered severe withdrawal symptoms. Feeling terrible, he restarted his oxycodone and is now in your office demanding you wean him off his medication.