Abstract
Principles of acute pain management in substance abuse patients focus on attaining adequate analgesia via a multimodal approach while being vigilant of the surrounding psychosocial and medicolegal issues. An understanding of the pathophysiology of pain is discussed, as it is fundamental to designing a rational multimodal treatment plan. A holistic therapeutic approach should be employed with clear and sustainable exit and entry strategies, with longitudinal follow-up whenever possible. The clinician must be able to identify and treat opioid-induced hyperalgesia as well as treat pain in the setting of patients receiving opioid maintenance therapy.
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References
Huxtable CA, Roberts LJ, Somogyi AA, MacIntyre PE. Acute pain management in opioid-tolerant patients: a growing challenge. Anaesth Intensive Care. 2011;39(5):804–23.
Substance Abuse and Mental Health Services Administration Public Health Service. U.S. Results from the 2010 national survey on drug use and health: summary of national findings. NSDUH Series H-41, HHS 2011; Publication No. (SMA) 11-4658.
National Center for Injury Prevention and Control. Policy impact: prescription painkiller overdoses. Centers for Disease Control Nov 2011. http://www.cdc.gov/HomeandRecreationalSafety/pdf/PolicyImpact-PrescriptionPainkillerOD.pdf
Liscinsky M. FDA introduces new safety measures for extended-release and long-acting opioid medications. 2012. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm310870.htm. Accessed 3 Jan 2013.
Markowitz JD, Francis EM, Gonzales-Nolas C. Managing acute and chronic pain in a substance abuse treatment program for the addicted individual early in recovery: a current controversy. J Psychoactive Drugs. 2010;42(2):193–8.
Krashin D, Murinova N, Ballantyne J. Management of pain with comorbid substance abuse. Curr Psychiatry Rep. 2012;14(5):462–8.
Manchikanti L, Helm 2nd S, Fellows B, Janata JW, Pampati V, Grider JS, et al. Opioid epidemic in the United States. Pain Physician. 2012;15(3 Suppl):ES9–38.
Mackenzie JW. Acute pain management for opioid dependent patients. Anaesthesia. 2006;61(9):907–8.
Alford DP, Compton P, Samet JH. Acute pain management for patients receiving maintenance methadone or buprenorphine therapy. Ann Intern Med. 2006;144(2):127–34.
Gandhi K, Heitz JW, Viscusi ER. Challenges in acute pain management. Anesthesiol Clin. 2011;29(2):291–309.
Palepu A, Tyndall MW, Leon H, Muller J, O’Shaughnessy MV, Schechter MT, et al. Hospital utilization and costs in a cohort of injection drug users. CMAJ. 2001;165(4):415–20.
Blay N, Glover S, Bothe J, Lee S, Lamont F. Substance users’ perspective of pain management in the acute care environment. Contemp Nurse. 2012;42(2):289–97.
Mehta V, Langford RM. Acute pain management for opioid dependent patients. Anaesthesia. 2006;61(3):269–76.
Compton MA. Cold-pressor pain tolerance in opiate and cocaine abusers: correlates of drug type and use status. J Pain Symptom Manage. 1994;9(7):462–73.
Neighbor ML, Dance TR, Hawk M, Kohn MA. Heightened pain perception in illicit substance-using patients in the ED: implications for management. Am J Emerg Med. 2011;29(1):50–6.
Tan S, Yeow M. Moses Maimonidies (1135-1204): Rabbi, Philosopher, Physician. Singapore Med J. 2002;43(11):551–3.
Rapp SE, Ready LB, Nessly ML. Acute pain management in patients with prior opioid consumption: a case-controlled retrospective review. Pain. 1995;61(2):195–201.
American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012;116(2):248–73.
Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol. 2009;22(5):588–93.
Carr DB, Goudas LC. Acute pain. Lancet. 1999;353(9169):2051–8.
Besson JM. The neurobiology of pain. Lancet. 1999;353(9164):1610–5.
Brennan TJ. Pathophysiology of postoperative pain. Pain. 2011;152(3 Suppl):S33–40.
Hurley RW, Wu CL. Acute postoperative pain. In: Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller’s anesthesia. 7th ed. Philadelphia: Churchill Livingstone; 2009. p. 2757–81.
Fu D, Froicu D, Sinatra R. Anatomic and physiologic principles of pain. In: Vadivelu N, Urman RD, Hines RL, editors. Essentials of pain management. Springer: New York; 2011. p. 31–44.
Ventafridda V, Saita L, Ripamonti C, De Conno F. WHO guidelines for the use of analgesics in cancer pain. Int J Tissue React. 1985;7(1):93–6.
Slevin K, Ballantyne J. Management of acute postoperative pain. In: Longnecker DE, Brown DL, Newman MF, Zapol WM, editors. Anesthesiology. 2nd ed. New York: McGraw-Hill Professional; 2012.
De Buck F, Devroe S, Missant C, Van de Velde M. Regional anesthesia outside the operating room: indications and techniques. Curr Opin Anaesthesiol. 2012;25(4):501–7.
Kettner SC, Willschke H, Marhofer P. Does regional anaesthesia really improve outcome? Br J Anaesth. 2011;107 Suppl 1:90–5.
Low Y, Clarke CF, Huh BK. Opioid-induced hyperalgesia: a review of epidemiology, mechanisms and management. Singapore Med J. 2012;53(5):357–60.
Crofford LJ. Adverse effects of chronic opioid therapy for chronic musculoskeletal pain. Nat Rev Rheumatol. 2010;6(4):191–7.
Murnion B. Management of opioid substitution therapy during medical intervention. Intern Med J. 2012;42(3):242–6.
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Fishman, M.A., Thomas, DA.M. (2015). Management of Acute Pain. In: Kaye, A., Vadivelu, N., Urman, R. (eds) Substance Abuse. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1951-2_33
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DOI: https://doi.org/10.1007/978-1-4939-1951-2_33
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