Associate Professor
Director
Pain and Chemical Dependency Program
Perelman School of Medicine University of Pennsylvania
Center for Study of Addiction
Philadelphia, PA
Individuals who suffer from chronic pain often present with significant medical and psychiatric comorbidities that can exacerbate the pain experience and contribute to a further erosion of quality of life and disability. Suicide is a serious side effect of chronic pain.
Dr. Cheatle reviews some medication and non-medication treatment options for addressing substance use disorder. The message to primary care: a multimodal approach works best, and treatment of the SUD without attention to management of the patient’s underlying pain is the likely route to relapse.
I think we’ve been so focused on this opioid crisis that we have forgotten that these are very brittle people who have significant psychiatric co-morbidities, including...
Current and Future Opioid Abuse Risk Assessment and Mitigation Strategies
Both chronic pain and the harms associated with prescription opioid abuse, including serious adverse events and fatalities, are enormous public health problems. Opioid therapy has been a cornerstone of a multimodal approach to the management of chronic pain. However, the increased rate of opioid prescriptions has been paralleled by the abuse of prescription opioids in the US, escalating more than 113% between 2004 and 2013. Recent clinical guidelines and professional society position papers for opioid prescribing recommend that prior to initiating opioid therapy in selected candidates, providers should screen patients to identify those at risk for developing an opioid use disorder (OUD) and that patients maintained on opioids long term should be routinely monitored for the development of aberrant drug related behaviors suggestive of abuse. (Recorded at PAINWeek 2019)