The Elephant in the Room: Helping Patients to Navigate the "O" Impasse

A pain psychologist will discuss the role of evidence-based behavioral treatment modalities that are known to result in improvement in physical and emotional functioning, including their use in the context of opioid weaning. The terms dependence, abuse, tolerance, and addiction are often used interchangeably when discussing opioid medication; however, use of the nomenclature in this fashion is erroneous. The differences between these words will be explained and the implications for treatment discussed. Clinical pathways that often lead to medication escalation will be identified. The role of behavioral interventions for pain treatment and the literature supporting their use will be reviewed, including data from an interdisciplinary clinical program which provides patients such education while concurrently reducing opioid medication.