Who: Elderly female patient
What: Chronic, stable opioid therapy
This patient had been on a consistent dose of pain medication for a long period of time and tolerated it well. She contracted Covid-19 and began experiencing respiratory depression in combination with her normal opioid. Her family called 911 and administered Narcan while EMS was in route. The patient was treated in the ED, did not suffer any further injuries, and recovered well.
Who: Elderly female patient
What: Chronic, stable opioid therapy
OUTCOME: Full recovery due to Narcan
Who: Elderly female patient
What: Chronic, stable opioid therapy
After taking a nap, this patient could not remember if she had already taken her medication upon waking, so she took what she thought was her prescribed dose although she had already taken her prescribed dose for the day. As a result, she accidentally took her husband’s medication, which was the same medication at a higher dose. She became dizzy and disoriented, and her husband was not able to help her. She was prescribed Narcan but did not fill it. This resulted in hospitalization and injury.
Who: Elderly female patient
What: Chronic, stable opioid therapy
OUTCOME: Hospitalization and injury
Who: Young male patient’s child
What: Post-op opioid therapy
This patient had a procedure requiring a few days of opioid therapy post-operatively, and he filled a Narcan prescription along with the acute pain medication that was prescribed. The medication was kept on the patient’s nightstand, and his child ended up accidentally consuming a pill. The patient administered Narcan to the child, and everyone was safe.
Who: Young male patient’s child
What: Post-op opioid therapy
OUTCOME: Full recovery due to Narcan
Who: Young female patient
What: Acute opioid therapy mixed with Benzodiazepines
This patient had difficulty sleeping due to ongoing pain. She was seen in the ED with lethargy, slurred speech, drowsiness, and confusion. The patient was inconsistent with reporting whether she took Xanax or Klonopin. She had no suicidal ideation, so she was cleared to go home and was referred to pain management. The hospitalist who treated her in the ED prescribed Tramadol for ongoing pain until she was able to follow up with her PCP or be seen by pain management. She was not prescribed Narcan. She was once again seen in the ED two weeks later for Klonopin and Tramadol overdose, and she admitted to taking more than her prescribed dose due to worsening pain. The patient was subsequently admitted for observation.
Who: Young female patient
What: Acute opioid therapy mixed with Benzodiazepines
OUTCOME: Hospitalization
Who: Older female patient
What: Acute opioid therapy mixed with Benzodiazepines
OTC meds were not effective for this patient with chronic pain who underwent surgery. She was then started on Oxycodone post-operatively but was not prescribed Narcan. The patient was eventually weaned to Tramadol but remained on this medication chronically. She had one abnormal urine drug screen, but subsequent screens were normal. She was prescribed opioids by multiple providers, but they were all in the same office. Six months later, she had a urine drug screen that was negative for all prescribed medications, and opioids were discontinued. The Patient had increased pain and scheduled a joint replacement with an orthopedist. Two weeks pre-surgery, she was prescribed Tramadol and Oxycodone for pain to tide her over. One week prior to surgery she overdosed on her prescribed medication and died.
Who: Older female patient
What: Acute opioid therapy mixed with Benzodiazepines
OUTCOME: Death
