31st January 2024

In GP, you do a medication review for a 55-year-old woman and find that a patient has been using increasing doses of codeine

In GP, you do a medication review for a 55-year-old woman and find that a patient has been using increasing doses of codeine for the past year for back pain. You discuss that this should not be used long-term and discuss a potential reduction plan. The patient becomes distressed by this suggestion, stating they could not cope without this, explaining that when they could not get their prescription filled for a few days, their pain worsened, and they could not sleep and felt restless with poor appetite. They also disclose they have also been topping up their dose with over-the-counter Nurofen Plus (ibuprofen and codeine) to try and cope with the pain. What would be the most appropriate initial management step in this scenario?

Select the SINGLE most appropriate option from the list below. Select ONE option only.