Mayara Nguyen, a 38-year-old accountant, has been prescribed opioids for the past year to manage chronic fibromyalgia pain. Initially, opioids were prescribed for flare-ups, but Mayara has started to use them more frequently. During her latest clinic visit, she requested an early refill for the third consecutive time, stating that she had lost her medication. The nurse practitioner (NP) notices that Mayara seems anxious and more focused on the medication than on discussing her overall pain management plan. She has been late to the last three appointments, seems to be wearing dirty clothes, and has also missed several appointments with the pain management specialist and recommended non-pharmacological therapies. When asked about tapering her opioid use, Mayara states she has been in severe pain recently, requiring her to miss work and would not be able to function without the opioids. Which of the following observations of Mayara’s behavior and recent history may indicate the development of opioid use disorder (OUD) related to prescribed opioid therapy?
[Expert Solution]: Mayara Nguyen, a 38-year-old accountant,…
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