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Seen in the ED: Heroin OD
A man of about 40-years-old is seen in the ED for a possible drug overdose. He complains of low back pain and asks for medication. What's your diagnosis?
History of present illness
A man of about 40-years-old with a history of heroin abuse, now on methadone, is brought to the ED for a possible overdose. He did not require Narcan but is somnolent. He has no other acute complaint but does mention he has chronic low back pain which has been worse for the past few months and he requests pain medicine. He denies any fever, weakness, bowel/bladder/balance issues or other symptoms.
Vital signs & physical examination
Vital signs are normal. Physical exam is normal except for a very large number of track marks.
Relevant imaging results
Radiograph, lumbar spine
What is the most likely diagnosis?
Primary Viewpoints Episode 7: Antidepressants for Back Pain, Osteoarthritis Pain
February 25th 2021Listen to our newest podcast episode where the lead author of a recent meta-analysis shares his findings on the safety and efficacy of antidepressant medications to treat back and osteoarthritis pain.
Podcast: Arthritis, Anxiety, and Depression: Managing a Common Comorbidity
May 14th 2012Anxiety is even more common than depression among people who have arthritis, a new study has shown. Here to discuss the implications for diagnosis and treatment is Eilzabeth Lin MD, a family medicine physician who is a longstanding researcher in the field of depression and pain.
