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John, a 46-year-old African-American male presents for admission to your hospital for hemi-colectomy for colon polyps. He is complaining of chronic back pain. Patient is on disability from work related injury. History of two (2) previous back surgeries with relief of numbness in RLE but pain has not been relieved. His current medications include Methadone, Neurontin and Norco. John states he takes Tylenol PM every night in addition to his prescribed medications. John is a smoker and smokes 1 PPD. John confides in you that he is considering a spinal cord stimulator for the chronic pain.

What risk factors does John have for risk of opioid withdrawal during this hospitalization?
Is there a stigma connected to being disabled and or methadone?
Does the nurse need to be concerned about acetaminophen use?
What are the differences in acute and chronic pain?

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