I have a real problem with giving narcotics to pts with known addiction. I understand the pain concept and I am usually very aware of my pts pain level, but when is enough. I had a pt who slept very hard all night, even through a blood draw, woke up and in a slurred voice asked me for his "rise and shine medicine". Demerol 75mg would not get me going in the morning. I held the med until he had woke up more. Was this wrong?
Another pt I had wanted something for nausea. The MD ordere Phenergan 50mg IV. I started with 12.5 mg. She asked for it every 2 hours, when I went it to give it she was fast asleep. She was also on a morphine PCA.
I guess my question is how do you determine when to keep giving narcotics or "rise and shine" meds.