A patient with opioid abuse arrives claiming pain and states he won't leave without a prescription. What is the MOST appropriate action?

Correct answer: B. Refer the patient appropriately for pain management and substance use treatment

• A. Incorrect. Calling 911 is appropriate if the patient becomes physically threatening or dangerous — the scenario describes verbal insistence, not necessarily a criminal threat.
• B. Correct. The appropriate management for a known opioid-abusing patient demanding opioids: perform a clinical examination, provide appropriate NON-OPIOID pain management for any genuine dental pain, and REFER to appropriate resources (physician, pain management, substance use treatment). Do not prescribe opioids, but do not simply abandon the patient.
• C. Incorrect. Prescribing opioids to a known opioid abuser on demand, without clinical indication, would be unethical and potentially illegal (contributing to substance abuse).
• D. Incorrect. Simply dismissing the patient without addressing his needs is inappropriate from both a care and risk management perspective.