Possible Signs of Prescription Drug Abuse
A new visit by Jonathan introduces several changes and unpredictable outcomes of the already prescribed treatment. Last time, the patient was provided with a pharmacological plan including a decreased dose of acetaminophen (500 mg), 10 mg of atorvastatin, and 200 mg of Ibuprofen as the main NSAID to address the patient’s pain. The combination of Ibuprofen and acetaminophen are effective for the patients, who want to reduce and control the level of pain (Rasubala, Pernapati, Velasquez, Burk, & Ren, 2015). This combination could hardly cause such negative outcomes as drug addiction and dependence. Still, the cases of prescription drug abuse are frequent among US citizens (Bagalman, Sacco, Thaul, & Yeh, 2014). It is wrong to ignore the possibility of prescription drug abuse considering the presence of certain changes in the patient’s behavior. The patient’s general look has changed: he is unshaved and diaphoretic, and his clothes are wrinkled. Besides, he offers to change the pharmacological treatment offered to him and ask to change Tramadol (Seago, Hayek, Pruszynski, & Newman, 2016) to Percocet. The reasons for such demand include the level of pain (10 out of 10) and the fast growth of pulse. However, all these behavioral and emotional changes may be defined as the possible signs of prescription drug abuse (McHugh, Nielsen, & Weiss, 2015). Therefore, in addition to the necessity to deal with pain, it is necessary to check if the chosen treatment is not effective.
Actions of NP in Case of Patient’s Return
The same patient could address to the hospital with the same demands and complaints again. The reasons for such a possibility include drug abuse and the inability to cope with pain independently. Besides, his alcoholic history and the inabilities to deal with bad habits could be an excuse. Therefore, the actions of the NP should be planned and evaluated. The use of NSAIDs and acetaminophen cannot be stopped not to promote the development of osteoarthritis (MacMullan, P., & McCarthy, 2012). Still, such lab tests as blood and urine analysis, ALT/AST level, and ultrasound of the liver should be made to clarify the condition of the organs that are at high risk because of acetaminophen. If the tests are normal, and the problems with the knee pain are absent, prescription drug abuse could be stated. The patient should be sent to a rehabilitation center and educated properly.
Education
Inappropriate use of drugs is a serious issue for consideration (Kirschner, Ginsburg, & Sulmasy, 2014). It is necessary to prove the patient with the crucial backgrounds in treatment and recovery. Two forms of treatment, pharmacological and non-drug, should be promoted. The patient has to be informed about the necessity to control his weight and diet. Regular exercises which are not harmful to a knee should be discussed with a doctor and a personal coach. Dietary changes are also preferable to add more vitamins to the patient’s ration. Besides, the patient has to know that the inappropriate use of drugs is a cause of death among Americans. It is easy to make a mistake. Therefore, each decision whether to change or stop taking drugs at all should be discussed with a nurse and a doctor. Finally, several case studies and educative movies have to be offered to the patient to demonstrate how self-care may influence people.
References
Bagalman, E., Sacco, L. N., Thaul, S., & Yeh, B. T. (2014). Prescription drug abuse. Journal of Drug Addiction, Education, and Eradication, 10(4), 459-479.
Kirschner, N., Ginsburg, J., & Sulmasy, L. S. (2014). Prescription drug abuse: Executive summary of a policy position paper from the American College of Physicians. Annals of Internal Medicine, 160(3), 198-200.
MacMullan, P., & McCarthy, G. (2012). Treatment and management of pseudogout: Insights for the clinician. Therapeutic Advances in Musculoskeletal Disease, 4(2), 121-131.
McHugh, R. K., Nielsen, S., & Weiss, R. D. (2015). Prescription drug abuse: From epidemiology to public policy. Journal of Substance Abuse Treatment, 48(1), 1-7
Rasubala, L., Pernapati, L., Velasquez, X., Burk, J., & Ren, Y. F. (2015). Impact of a mandatory prescription drug monitoring program on prescription of opioid analgesics by dentists. PloS One, 10(8). doi: 10.1371/journal.pone.0135957
Seago, S., Hayek, A., Pruszynski, J., & Newman, M. G. (2016). Change in prescription habits after federal rescheduling of hydrocodone combination products. Proceedings (Baylor University. Medical Center), 29(3), 268-270.