Medical practitioners should always be wary of administering pain medication in order to prevent errors that could lead to patient harm. Safe and effective pain assessment and management should always begin with determining the intensity of pain if the patient is able to report it. Lack of a method to quantify pain makes it difficult to determine the range of pain that Howard, for example, might be feeling. Therefore, the nurse should carry out a thorough drug history assessment before provision of medication (Hudspeth, 2016). Once this process is complete, the decision to proceed with treatment should be made based on the results obtained. Patients with a history of drug abuse should be referred to an expert for treatment.
The Controlled Substances Act stipulates five schedules of medication for controlled substances. Schedule I drugs have a high risk of misuse and lack FDA approval. Examples include heroin and LSD (Juergens, 2019). Schedule II drugs have a high risk of misuse but also have accepted clinical use. Examples include morphine and codeine. Schedule III drugs have intermediate potential of misuse. They include ketamine and anabolic steroids among others. Schedule IV drugs are considered to have a lower risk that schedule III (Juergens, 2019). Examples include clonazepam and midazolam. Schedule IV drugs have the lowest risk of misuse. They include promethazine and pregabalin.
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The initial prescription would be a short acting narcotic prescribed for a short period to assess the patient’s response to the medication. Short acting narcotics should be administered to maintain consistent control of the condition as soon as possible (Pasero & Quinlan-Colwell, 2016).The patient should be scheduled for a subsequent visit to assess their condition and monitor any red flag behaviors that suggest narcotic misuse. The patient should be advised to seek alternative treatment options to ease the pain before initiating the transition from short acting narcotics to long acting narcotics.
References
Hudspeth, R. S. (2016). Safe Opioid Prescribing for Adults by Nurse Practitioners: Part 2. Implementing and Administering Treatment. The Journal for Nurse Practitioners , 2013-220.
Pasero, C., & Quinlan-Colwell, A. (2016). American Society for Pain Management Nursing Position Statement: Prescribing and Administering Opioid Doses Based Solely on Pain Intensity. Pain Management Nursing , 170-180.
Juergens, J. (2019, December 6). Controlled Substance Schedules. Addiction Center. https://www.addictioncenter.com/addiction/controlled-substances-act-and-scheduling/
