Question

A 58-year-old woman with chronic low back pain from degenerative disc disease has been taking oxycodone 40 mg twice daily for 3 years with limited benefit and increasing constipation. She has tried physiotherapy and NSAIDs but not other adjuvant agents. According to the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain and subsequent updates, what is the most appropriate next step?

Accepted Answer

Begin tapering opioids while optimising non-opioid pharmacologic and non-pharmacologic therapies

Answer

Increase her oxycodone dose to improve analgesia

Answer

Switch to a more potent opioid such as hydromorphone

Answer

Continue her current regimen indefinitely if she is not misusing the medication

Answer

Add benzodiazepines to improve sleep and pain control

Practice question