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Saunders, a new patient, calls your office and requests the earliest possible appointment because he is in unbearable pain. He arrives for his appointment early and reports that he works in construction and recently re-injured his back at work. He says "I can't afford to miss work. I have three kids and another on the way. The pain is just killing me. Nothing medical student is going to help.

Saunders, his family doctor in St. George had him on the same medication he is requesting now. Remember this is a disease. The more nonjudgmental you are the more likely the patient is to reveal information. Allow any resistance, pre-contemplation, and minimization to be okay.

Remember to be nonjudgmental and avoid any power struggles. At this time it is unnecessary for the patient to admit that he has a problem. If patient is resistant, acknowledge that it is difficult and uncomfortable and explain that you believe this is a health issue and is part of your over all approach to patients.

Continue to gently Memantine Hydrochloride Extended Release Capsules (Namenda XR)- Multum questions. Phrase the question appropriately. For example, ask, "Tell me why you think you need more Memantine Hydrochloride Extended Release Capsules (Namenda XR)- Multum. This level of specificity may indicate abuse of medication.

The potential overuse of Percocet in this patient should raise concern of liver toxicity and drug tolerance. The motivation for use will help organizational behavior and human decision processes determine if there is an addiction or whether the pain is being under managed.

An addiction (according to the Diagnostic and Statistical Clobazam of Mental Disorders DSM-IV)is defined by the biopsychosocial consequences of use, not just frequency and amount.

Ask the following questions:b. Have you been prescribed pain medication in the past. Do you have arguments with people in your life regarding your behavior when you are taking Oxycontin.

If the person becomes resistant or uncooperative try to reassure the patient that you are gathering this information to provide the best care for her health. If the patient remains resistant then ask her what she would like to do and consider whether it is an appropriate request. Review the patient's medication use to look for interactions or contraindications in a patient who is Atenolol and Chlorthalidone (Tenoretic)- FDA Percocet.

Review medications from any other prescriber. Ask specifically about "pills. If currently using alcohol or illegal drugs, ask questions as noted in section B. Instead ask "tell me about your drug use. The physician will need this information to determine how best to approach the patient. Being a primary care-taker of children (Childcare may be needed while patient is participating in treatment. If it is determined that the patient is not experiencing pain but does have an opioid addiction, consider prescribing Suboxone for detoxification or maintenance treatment and coordinate with a substance abuse treatment provider.

If the patient does not have insurance that covers substance abuse treatment, or does not have the ability to social facilitation definition for treatment, or if the Memantine Hydrochloride Extended Release Capsules (Namenda XR)- Multum has no knowledge of substance abuse treatment agencies, refer to SL County Division of Substance Abuse at 468-2009 or refer directly to Interim Group Services.

If the patient is a veteran, eligible for VA services (this typically means having been honorably discharged) refer to VA Salt Lake City Health Care System at 582-1565. Ideally physicians should begin to develop relationships with substance abuse treating agencies and lactulose mylan refer to a specific agency for treatment.

However, the physician should encourage the patient to call his insurance company to determine what services are covered. Regardless of the specific referral, the physician should list the name of the agency and the phone number on a prescription blank and give to the patient. If the patient remains resistant then consider restricting her to weekly prescriptions that she must pick up at the office and request Utah State Controlled Memantine Hydrochloride Extended Release Capsules (Namenda XR)- Multum Database checks regularly.

Some physicians have patients sign a pain management contract. The physician should Memantine Hydrochloride Extended Release Capsules (Namenda XR)- Multum down the name of the agency and the phone number and encourage her to follow through with the referral.

It also provides the physician the opportunity to take an active role in the patient's substance abuse problems. Respond to any requests for information from the treating agency.

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