The patient is a 58-year-old woman with chronic pain due to inflammatory arthritis. She presents for her first appointment with you in a primary care office. She states that she is aware that she is asking for an early refill of her Oxycontin however she is traveling out of state and she is concerned that she may have a flare-up on her trip.
Apply the steps in screening, brief intervention, and treatment (SBIRT) to this scenario
Identify additional questions for this patient
Develop a treatment plan for this patient
2. The patient is a 24-year-old man brought to your clinic by his family for an evaluation. The patient states that he is struggling with prescription pain pills and wants help. He appears to be in opioid withdrawal; he describes anorexia and diarrhea, he is yawning and sweating upon examination. He scores 15 on the Clinical Opioid Withdrawal Scale (COWS), indicating moderate withdrawal.
Initiate office-based buprenorphine/naloxone (Suboxone) with a plan for observation.
Include your rationale for each treatment decision
Develop a treatment plan for this patient that includes ongoing medication-assisted treatment (MAT) and psychosocial treatment interventions.
Construct a safe taper schedule for a patient taking alprazolam (Xanax) 2mg TID. Include a brief narrative explaining the evidence for tapering a patient who has been on a benzodiazepine for an extended amount of time.
