Who: Young female patient
What: Acute opioid therapy mixed with Benzodiazepines
This patient had difficulty sleeping due to ongoing pain. She was seen in the ED with lethargy, slurred speech, drowsiness, and confusion. The patient was inconsistent with reporting whether she took Xanax or Klonopin. She had no suicidal ideation, so she was cleared to go home and was referred to pain management. The hospitalist who treated her in the ED prescribed Tramadol for ongoing pain until she was able to follow up with her PCP or be seen by pain management. She was not prescribed Narcan. She was once again seen in the ED two weeks later for Klonopin and Tramadol overdose, and she admitted to taking more than her prescribed dose due to worsening pain. The patient was subsequently admitted for observation.
Who: Young female patient
What: Acute opioid therapy mixed with Benzodiazepines
OUTCOME: Hospitalization
Who: Older female patient
What: Acute opioid therapy mixed with Benzodiazepines
OTC meds were not effective for this patient with chronic pain who underwent surgery. She was then started on Oxycodone post-operatively but was not prescribed Narcan. The patient was eventually weaned to Tramadol but remained on this medication chronically. She had one abnormal urine drug screen, but subsequent screens were normal. She was prescribed opioids by multiple providers, but they were all in the same office. Six months later, she had a urine drug screen that was negative for all prescribed medications, and opioids were discontinued. The Patient had increased pain and scheduled a joint replacement with an orthopedist. Two weeks pre-surgery, she was prescribed Tramadol and Oxycodone for pain to tide her over. One week prior to surgery she overdosed on her prescribed medication and died.
Who: Older female patient
What: Acute opioid therapy mixed with Benzodiazepines
OUTCOME: Death
