Requirements

Complete the following case studies:

1. The patient is a 58-year-old woman with chronic pain due to inflammatory arthritis. She presents for her first appointment with you in a primary care office. She states that she is aware that she is asking for an early refill of her Oxycontin however she is traveling out of state and she is concerned that she may have a flare up on her trip.

• Apply the steps in SBIRT to this scenario
• Identify additional questions for this patient
• Develop a treatment plan for this patient

2.The patient is a 24-year-old man brought to your clinic by his family for an evaluation. The patient states that he is struggling with prescription pain pills and wants help. He appears to be in opioid withdrawal; he describes anorexia and diarrhea, he is yawning and sweating upon examination. He scores 15 on the Clinical Opioid Withdrawal Scale (COWS), indicating moderate withdrawal.

• Initiate office-based buprenorphine/naloxone (Suboxone) with a plan for observation.
• Include your rationale for each treatment decision
• Develop a treatment plan for this patient that includes ongoing MAT and psychosocial treatment interventions.
• Construct a safe taper schedule for a patient taking alprazolam (Xanax) 2mg TID. Include a brief narrative explaining the evidence for tapering a patient who has been on a benzodiazepine for an extended amount of time.

Foli, K. J., Huang, W., Adams, N., Kersey, S., Good, B., Ott, C., & Duha, M. S. (2021). Nurses’ Substance Use Education Through a Massive Open Online Course (NSUE-MOOC). Purdue University, School of Nursing, West Lafayette, Indiana.

Solution:

Case study 1

Apply the steps in SBIRT to this scenario

To identify and provide services to people at risk of a substance use disorder, depression, and other mental health issues, screening, Brief Intervention, and Referral to Treatment (SBIRT)  approach is used (Hargraves et al., 2017). In the case of a 58-year-old woman who asks for a refill of her oxycontin, using SBIRT can help to identify the patient early and assist in the treatment. The primary care provider can therefore screen the patient and offer access to SBIRT treatment services.

• Screening: This is the first step, which aims at assessing the patient for risky substance use behavior. In the 58-year0old, a risk behavior of requesting early refill is identified, hence screening is required. The urgent need to take the drug on a daily or regular basis when she is traveling further supports the need for screening. The recommended tool that can be used to screen this patient is the Drug Abuse Screen Test (DAST-10). This test will help to determine if the patient is abusing drugs and show if she is at low, moderate, or high risk of complications from drug abuse……..To access the solution  click the icon below to purchase at $10