Current Psychiatry Reports

, Volume 14, Issue 5, pp 462–468

Management of Pain With Comorbid Substance Abuse

  • Daniel Krashin
  • Natalia Murinova
  • Jane Ballantyne
Substance Use and Related Disorders (JR McKay, Section Editor)

DOI: 10.1007/s11920-012-0298-3

Cite this article as:
Krashin, D., Murinova, N. & Ballantyne, J. Curr Psychiatry Rep (2012) 14: 462. doi:10.1007/s11920-012-0298-3

Abstract

Substance use disorders are a large public health problem in the United States. Over the past decade, there has been a trend of increased prescription drug misuse, morbidity, and mortality related to prescription opioids. For providers who treat pain, this has led to clinical dilemmas as the newly appreciated risks must be balanced with the benefits of treatment, particularly in patients with known substance use disorders. Acute, chronic, and palliative each present distinct issues in pain treatment. A best practices model of pain treatment, including risk stratification and integrative treatment, may provide the best prospect for safe and effective treatment.

Keywords

AddictionSubstance abuseAcute painChronic painPalliative careCancer painAberrant behaviorOpioid abuseOpioid addictionOpioid dependenceDrug diversionOpioid toleranceRisk managementRisk stratificationScreeningPain managementUrine drug screeningPsychological testingSubstance abuse treatment

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Daniel Krashin
    • 1
  • Natalia Murinova
    • 2
  • Jane Ballantyne
    • 1
  1. 1.Anesthesiology and Pain MedicineUniversity of Washington Medical CenterSeattleUSA
  2. 2.NeurologyUniversity of Washington Medical CenterSeattleUSA