What Do You Mean Pain Meds?

Hey friends 👋🏻

You and I are probably thinking the same thing.

What exactly is the patient withdrawing from? Do I need to start thinking about buprenorphine?

In case you haven’t seen my carousel, I was once approached by an attending because they weren’t too sure what the patient was withdrawing from. All I knew at the time was this:

SP! The patient said they were taking “pain meds” and are now withdrawing.

The urine drug screen was negative for opioids but positive for benzos. The prescription drug monitoring program only showed recent benzo fills.

I knew at the time I wasn’t going to order a confirmatory test because the turnaround time can be up to a week. I didn’t have a week to figure out what was in front of me.

So I did it the old school way.

Ask the patient.

SP: Hey, I was told you were withdrawing from pain meds. Are we talking about opioids or something else?

Patient: No, I don’t take opioids. I take Klonopin for pain.

Ahhhhhh. Well, that explains everything.

There is a quote from the book Unreasonable Hospitality that really hits home:

The customer’s perception is your reality.

If the patient believes what they take is a pain med, then we cannot always assume their pain med is our pain med.

Here’s something about the nature of the consults I get.

Sometimes they are heavily involved in clinical reasoning. But in this case,

It was about clarifying.

PS: I’m going to announce more details about the Origami and Opioid Workshop. Stay tuned.

Thanks for reading 🙇🏻

SP