“Does anyone have thoughts about Mr. Jones?” I ask around the table. My primary care team sees veterans who were recently homeless. Many have been severely injured, and half have chronic pain. We have wise nurses, a committed social worker, and something else: time to focus on a vulnerable group.
And here we are today we have Mr. Jones. A bit about his case. He has a history of shoulder pain dating back to some failed surgery for fractures. I’ve changed some details to protect his confidentiality. Mr. Jones was once homeless, but he isn’t now. We prescribe opioids that another doctor started before we met him. But Mr. Jones is on high doses. And research data show that his overdose risk is somewhat higher because of that.
Mr. Jones lives in a rural community with his wife. He takes care of the garden and does all the chores. He says the pills make it possible. My team and I have looked for any hint of illicit drug use, and found none. The nurses believe he’s doing well. We’re attempting to reduce the dose, but if Mr. Jones can’t tolerate that, we won’t cut him off.
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