Never undertreat pain

[cbrons]

Here is a (paraphrased) question from the most popular and widely used QBank to prepare for USMLE Step 2CK:
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Man with history of opioid dependence gets in car accident. He is in severe pain. What is the appropriate treatment?

Answer: IV morphine

Explanation (word for word excerpt): "Physicians should never undertreat pain, even if there is a risk for abuse."

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I actually dont believe that at all. With an out-of-control opioid epidemic, I don't see how absolutes like this can be endorsed.

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[lobelsteve]

Here is a (paraphrased) question from the most popular and widely used QBank to prepare for USMLE Step 2CK:
----------------------------------------------
Man with history of opioid dependence gets in car accident. He is in severe pain. What is the appropriate treatment?

Answer: IV morphine

Explanation (word for word excerpt): "Physicians should never undertreat pain, even if there is a risk for abuse."

----------------------------------------------

I actually dont believe that at all. With an out-of-control opioid epidemic, I don't see how absolutes like this can be endorsed.

Sent from my SM-N910P using SDN mobile

He is in a controlled setting and not being prescribed medicine. It is being administeted. Addiction is not terribly relevant in this scenario.

At least that is what the Boards are going for.

 

[cbrons]

He is in a controlled setting and not being prescribed medicine. It is being administeted. Addiction is not terribly relevant in this scenario.

At least that is what the Boards are going for.

Yes but what do you think of the axiom in the explanation?

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[lobelsteve]

Yes but what do you think of the axiom in the explanation?

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It is nonsense. And dangerous.

 

[geauxg8rs]

It is nonsense. And dangerous.

I guess page the harpist on call was not an option?

 

[deleted185747]

It takes a long time to change, add or delete board questions which is why they lag by several years. Pretty soon board questions will match the extreme pendulum undulation.

 

[Yo GabbaPentin]

Here is a (paraphrased) question from the most popular and widely used QBank to prepare for USMLE Step 2CK:
----------------------------------------------
Man with history of opioid dependence gets in car accident. He is in severe pain. What is the appropriate treatment?

Answer: IV morphine

Explanation (word for word excerpt): "Physicians should never undertreat pain, even if there is a risk for abuse."

----------------------------------------------

I actually dont believe that at all. With an out-of-control opioid epidemic, I don't see how absolutes like this can be endorsed.

Sent from my SM-N910P using SDN mobile

The answer is right, but explanation is garbage. The guy has opioid dependence in the question, not addiction. Even if it were addiction, you still have to treat someone in acute pain due to trauma.

 

[freddydpt]

The answer is right, but explanation is garbage. The guy has opioid dependence in the question, not addiction. Even if it were addiction, you still have to treat someone in acute pain due to trauma.

I think you hit the nail on the head. It's this sort of thing that has propagated the opioid epidemic. Clearly, this patient would not be treated with ONLY IV morphine. He would have tylenol, an NSAID, an antidepressant, an anticonvulsant and a multimodal, multidisciplinary approach would be used. He'd also have regional anesthesia as indicated. - THAT is the appropriate answer and not "IV morphine".