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Treatment of Acute Pain in Patients on Naltrexone: A Narrative Review

  • Acute Pain Medicine (R Urman, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The tissue damage and trauma associated with surgery almost always result in acute postoperative pain. The intensity of postoperative pain can range from mild to severe. Naltrexone is suitable for patients who do not wish to be on an agonist treatment such as methadone or buprenorphine. However, naltrexone has been shown to complicate postoperative pain management.

Recent Findings

Multiple studies have found that the use of naltrexone can increase the opioid requirement for postoperative pain control. Other modalities exist that can help outside of opioids such as ketamine, lidocaine/bupivacaine, duloxetine, and non-pharmacological management can help manage pain. Multimodal pain regiments should also be employed in patients.

Summary

In addition to traditional methods for postoperative pain management, other methods of acute pain control exist that can help mitigate opioid dependence and help control pain in patients who use naltrexone for their substance use disorders.

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Data Availability

All data in this manuscript is publicly available on PubMed.

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Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA

    Amber N. Edinoff

  2. Louisiana Addiction Research Center, Shreveport, LA, 71103, USA

    Amber N. Edinoff, Elyse M. Cornett & Alan D. Kaye

  3. School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX, 78235, USA

    Chelsi J. Flanagan

  4. School of Medicine, Louisiana State University Health Science Center at New Orleans, New Orleans, LA, 70112, USA

    Evan S. Sinnathamby

  5. School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA

    Nathan Z. Pearl

  6. University of Arizona College of Medicine- Phoenix, Phoenix, AZ, 85004, USA

    Eric D. Jackson & Danielle M. Wenger

  7. Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA

    Elyse M. Cornett & Alan D. Kaye

  8. Thomas J. Long School of Pharmacy and Health Sciences, Department of Pharmacy Practice, University of the Pacific, Stockton, CA, 95211, USA

    Adam M. Kaye

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Contributions

A. N. E was responsible for the conceptualization of this manuscript. A. N. E., C. J. F., E. S. S., and N. Z. P were responsible for the writing of the original manuscript. A.N.E., E.D.J, D.M.W., E.M.C., A.M.K., and A.D.K. were responsible for all revisions of the manuscript. All authors give consent for the publication of this manuscript in this journal.

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Correspondence to Amber N. Edinoff.

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This narrative review did not require consent from subjects or review by an institutional review board.

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Edinoff, A.N., Flanagan, C.J., Sinnathamby, E.S. et al. Treatment of Acute Pain in Patients on Naltrexone: A Narrative Review. Curr Pain Headache Rep 27, 183–192 (2023). https://doi.org/10.1007/s11916-023-01110-9

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