A patient with a known history of opioid addiction requires post-operative analgesia after oral surgery. What is the MOST appropriate analgesic choice?

Correct answer: B. Acetaminophen alone

• A. Oxycodone is a Schedule II opioid with high abuse potential — contraindicated in patients with opioid addiction history.
• B. CORRECT. In a patient with opioid addiction history, ALL opioid medications (including tramadol, which has opioid activity) must be avoided. Acetaminophen (APAP) alone, often combined with NSAIDs (e.g., ibuprofen) in an alternating regimen, is the safe analgesic choice. Non-opioid multimodal analgesia is the current standard for such patients.
• C. Tramadol has mu-opioid receptor agonist activity and significant addiction potential — it is contraindicated in patients with opioid addiction history.
• D. Hydrocodone is a Schedule II opioid — absolutely contraindicated in patients with opioid addiction history.