A patient requests hydrocodone by name, stating it's the only medication that has ever worked for his pain. What is a reasonable approach for the dentist to consider?

Given the specificity of insisting on one particular controlled substance by name as 'the only thing that works,' referring the patient to a physician for broader pain management evaluation (and potentially establishing a documented care relationship, checking a prescription drug monitoring program, etc.) is a reasonable, defensible approach — while still ensuring any genuine underlying dental pathology is appropriately diagnosed and addressed directly.