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Theo is a 50-year-old male patient. He is prescribed tramadol 100mg TID for chronic pain.Ê Theo is experiencing panic attacks. These symptoms have been intense and causing him to present to the emergency department. Theo has been prescribed a variety of SSRI medications in the past. He has had intolerable side effects. He has been prescribed lorazepam in the emergency department with remission of panic symptoms and no side effects. Theo would like to continue the lorazepam on an outpatient basis as needed. Given tramadol is a controlled substance, you look up prescription fill history in your state's PDMP. There are no overt signs of overuse. Theo is using one provider and one pharmacy to fill this medication. He is agreeable to provide a urine drug test at any time and has signed a release of information for his provider. What would be the most appropriate next step? Group of answer choices Decline to prescribe lorazepam to Theo as tramadol is an opioid. Offer to refer him to a second opinion. Theo has no other risk factors for substance use or misuse. He has demonstrated appropriate use of Tramadol and is willing to work collaboratively with his other providers.
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