Treatment Strategies for the Opioid-Dependent Patient

  • Shweta Teckchandani
  • Meredith Barad
Migraine and Beyond (R Cowan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Migraine and Beyond


Purpose of Review

This review is intended to help the headache physician think through and plan for management issues concerning the use of opioids. We ask the headache physician to consider if there are instances where prescribing or continuing prescriptions of opiates is plausible, and if so, how can the physician proceed as safely as possible. Our goal is to start a conversation regarding the inevitable encounter with a patient on opiates or requesting opiates.

Recent Findings

The use of opiates in our society has reached a crisis in staggering death and addiction rates. Recent guideline published by the CDC can assist us in developing an algorithmic approach towards opiate use. Recent advances in addiction medicine can also assist us in protecting our patients.


Every headache physician will undoubtedly encounter patients on opiates. There still are appropriate reasons to treat patients with opiates. Every headache physician may need to prescribe opiates and they may be indicated. It is important to learn the correct way to approach, manage, and treat patients on opiates.


Addiction Opiate abuse Prescribing opiates Opioid management 



We would like to thank Anna Lembke and Howard Kornfeld for their assistance with this manuscript.

Compliance with Ethical Standards

Conflict of Interest

Shweta Teckchandani declares that he has no conflict of interest. Meredith Barad reports participation in clinical trials supported by ATI, Alder, Lilly, Capnia, TEVA, and Allergan.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Stanford Headache and Facial Pain Program, Department of Neurology and Neurological SciencesStanford University School of MedicinePalo AltoUSA
  2. 2.Division of Pain ManagementStanford School of MedicineRedwood CityUSA

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