Interactive diabetes case 19: Pain and dysesthesias of the lower extremities in a 29-year-old patient with type 1 diabetes (distal sensory neuropathy) – A2

ANSWER — 

Incorrect.

While narcotic analgesics are effective for the control of neuropathic pain, as well as other types of pain, they are never indicated as first-line treatment for painful diabetic neuropathy. The side effects, including constipation and the potential for opioid use disorder, are contraindications to their use. The particular agent offered (oxycodone CR [controlled release]) is especially associated with opioid use disorder. In very rare situations, where all other classes of medication indicated for painful diabetic neuropathy have been ineffective at maximally recommended or tolerated doses, a trial of a narcotic may be appropriate in patients without a history of substance use disorder.

Return to the beginning to try again. (See "Interactive diabetes case 19: Pain and dysesthesias of the lower extremities in a 29-year-old patient with type 1 diabetes (distal sensory neuropathy)".)