Our son was hospitalized over the weekend for a drug overdose. We almost lost him. We knew he was taking pain killers for a back injury. We just didn't know how much pain he was in, or that he was taking too many pills. Isn't there some way for doctors to monitor this a little more closely? Everything he was taking was by prescription.

Unintentional drug overdose can be a major problem when treating chronic back pain. Patients aren't always honest about their pain levels or the amount of medication they are taking. Sometimes they go doctor shopping. This refers to a pattern of going from doctor to doctor getting multiple prescriptions for the same type of drugs. In other cases, they get prescription drugs from other people. Getting drugs prescribed for others is called drug diversion. Many unintentional drug overdoses involve multiple drugs and intoxicants such as alcohol. Doctors do try to limit and monitor opiate drug use. Sometimes it's a fine line. They know these drugs have a positive, beneficial effect for pain sufferers. They also know some people are more susceptible to addiction, abuse, and overdose. The problem is there isn't a neat equation to use when figuring out who might be likely to engage in these behaviors. There are some guidelines physicians can use when prescribing and monitoring long-term use of opioid medications for chronic pain. These include: taking an alcohol and other drug use history with each patient. Provide regular follow-up visits, which include reevaluating opioid use and dosage. Require urine samples for drug testing before renewing each drug prescription. Some physicians use a written contract with each patient. The contract is reviewed each time the drug is renewed.

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