Takeaway
Nonjudgmental communication can help us understand the true nature of a patient’s condition and motivations. Connecting more deeply with a patient over time allowed us to learn more of the story.
Lifelong Learning in Clinical Excellence | October 10, 2024 | 1 min read
By Amani Algubari, MD, Farwaniya Hospital, Kuwait & Amy Yu, MD, Johns Hopkins Medicine
While completing an observership at the addiction medicine unit at Johns Hopkins, one encounter particularly stood out. A patient had been prescribed benzodiazepines to manage anxiety. She initially told us that she’d depleted her entire month’s supply within days and obtained additional doses from illicit sources for the rest of the month. Additionally, she disclosed intermittent use of fentanyl.
Her urine toxicology showed no evidence of benzodiazepine consumption. After further discussions over the course of two days, she said something surprising: she wasn’t using the benzodiazepines herself. Instead, she’d sold her prescribed supply and used that money to buy fentanyl.
We were then able to provide her with the appropriate care by addressing fentanyl use directly, implementing a tailored treatment plan, and offering the necessary support to guide her on the path to recovery.
This situation led me to consider how we can prevent misuse of prescribed medications and how to deal with it when it occurs.
1. Gain trust.
It’s important to identify patterns of misuse in patients prescribed medications that could potentially lead to a substance use disorder. During the patient interview, the clinician was extremely open, supportive, and nonjudgmental. This approach led the patient to share about misusing the medications. It showed how much building rapport with patients can pay off.
2. Engage in effective communication with the prescribing physician.
It’s essential to communicate with the patient’s prescribing doctor promptly and collaborate with them and the patient on a treatment plan.
3. Confront the patient with empathy and assertiveness.
It’s crucial to convey support for the patient while also setting boundaries and informing patients that they can no longer receive prescriptions for misused medications.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.