How to Answer Maxwell Arrives Clinic Questions (Complete Guide)
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Key Explanation
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Original Question
Maxwell, 32, arrives in the clinic today to talk about his opioid dependence. He said it began after a motorcycle accident, which happened 4 months ago. At that time, Maxwell was prescribed Percocet (oxycodone and acetaminophen) for pain control since he fractured multiple bones during the accident. However, he is still taking the Percocet four to five times daily. He states he has tried to cut back on the pain medication but has withdrawal symptoms whenever he tries to decrease the amount of medication he is taking daily. Maxwell has heard there is medication-assisted treatment to help him wean off the opioids. Maxwell states he took a dose of Percocet before bed the evening before coming to the clinic. On your exam you find an alert, well-nourished, cooperative patient. Vital signs are stable. Clinical Opioid Withdrawal Scale (COWS) score is 12. Scarring of legs and shoulder noted from old injury. Please address the following: Describe the plan of care for a patient requesting medication-assisted therapy for withdrawal from opioids? Please explain your rationale for this decision. Describe how buprenorphine is discontinued. Why does this medication need to be discontinued in this manner?
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