“Patients in recovery from opioid dependence or addiction present a conundrum when needing management of acute, severe pain. Not only is there a fear of addiction relapse among the patients and clinicians, but routine analgesic regimens also may not be sufficient to properly manage pain, especially in those receiving buprenorphine (or buprenorphine/naloxone combination), methadone, or naltrexone. Inadequate pain management has serious ramifications, including prolonged hospital stays, increased medical costs, unnecessary suffering, impaired quality of life, and progression to chronic pain.] Therefore, it is imperative that clinicians become knowledgeable in the management of pain in patients taking buprenorphine, methadone, or naltrexone.
In order to effectively treat patients on maintenance addiction treatment, it may be helpful to dispel common misconceptions that result in undertreatment of these patients. Alford and colleagues describe four such misconceptions associated with opioid agonist therapy:”
- Maintenance opioid therapy provides analgesia;
- Addiction relapse may occur from use of opioids for analgesia;
- Opioid analgesics may cause respiratory and central nervous system (CNS) depression in patients receiving opioid agonist therapy; and
- Reporting pain may be a manipulation to obtain opioid medications (“drug seeking”).
Read more at: http://www.medscape.com/viewarticle/839359
Source: Medscape.com – February 6, 2015