300 mgs of Gabapentin HS for that pain; why not just go with a placebo? Seriously and no snark intended, having worked past in oncology to this day longer than any other speciality made me a patient advocate for treating pain, I have seen some horrible deaths. Most people fear dying in pain more than they fear dying and how much time can a 90 year-old have left.
As the 90 year-old would be tested for her Rx which I completely agree with given she cannot advocate for herself she'd be testing positive, if this were my mother I'd run to another clinic. It would be different if all of this were related to med side effects only but if that were they case there are a host of meds elderly patients would not be receiving. All blood thinners, all chemotherapeutic agents, a host of various anti-hypertensives and the Ibuprofen we hand out like candy on Halloween.
I'm not stating this is the case with you but in the general we are not treating pain for #1 primary reason being 'the war on drugs; part two', I remember part one in the 1980s wherein inner city kids were tossed in jail forever over crack cocaine while the well-heeled snorted same drug off of discotheque tables. As for the same inner city folks they've always had heroin addicts as well, they did not go anywhere and they still OD.
Yet every 'cautionary tale' involves white people so we had to declare a crisis. We even renamed it 'opiate use disorder' for them and push Suboxone like candy in spite of the fact it has an opiate.
I actually don't fault providers as their fear of the DEA is well-founded, providers make easy targets; they don't shoot back and keep good records but, as with most things when the pendulum swings it swings to polar opposite with every well-heeled parent of a white OD wanting a new law after lil white Bobby/Susie. We give massive doses of methadone to heroin addicts and hand out 5/325 mgs Norco to cancer patients. I do not see the equity in this and working in corrections the vast majority of inmate withdrawing from methadone/Suboxone also use heroin, they tell me it's quite easy as methadone clinics just test for opiate metabolites which they will have (they don't get methadone in jail; very few controlled drugs in jail due to contraband misuse.)
But I digress, the elderly frequently have the most chronic pain and are the most undertreated due to everyones' concern for side effects on this specific class of drugs. So...we make sure we treat that HTN and A-fib in the interest of extending everyones' life without regard to their quality of life.