Throughout training, physicians are taught how to prescribe medications. How does the medication work within the body? Which patients will benefit? What is the appropriate dose? What are the side effects? The cost? We spend years honing our expertise on how to prescribe medications safely and correctly. Great care is taken to prescribe the best medication for each situation in each patient. We become comfortable prescribing medications early in training. Over the course of a patient’s lifetime, the number of these medications can build, leading to polypharmacy.
A 34-year-old male presented to a family medicine physician for chronic low back pain. The physician is comfortable prescribing opioids and has many patients on scheduled drugs. The patient has had chronic pain for many years and has undergone multiple treatments including physical therapy, steroid injections and many medications. On presentation, the patient was on Robaxin and oxycodone (four times a day). His past history is positive for hypertension and alcohol abuse, although he stated he hasn’t drank in the past year. He works as a laborer.
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