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Chronic Pain Patients and Substance Abuse

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Substance Abuse

Abstract

The physical and mental states of human beings are governed by lifetime experiences and biopsychosocial makeup. They reinforce each other, and sometimes lead to maladaptive states, such as chronic pain, addiction, and so on. Pain and addiction are altered biopsychosocial experiences that are both subjective in nature and interact with one another. This interface of pain and addiction has brought about serious public health problems. It also poses ethical and healthcare dilemmas through the conflicting goals of managing pain states: pain relief, i.e. beneficence, and “do no harm”, i.e. nonmaleficence [Geppert C. To help and not to harm: ethical issues in the treatment of chronic pain in patients with substance use disorders. In: Clark MR, Treisman GJ, editors. Pain and depression. An interdisciplinary patient-centered approach. Adv Psychosom Med. Basel: Karger; 2004:25:151–71]. With the rise of medicinal management for chronic pain over the last two decades, addiction has become more prevalent, significantly increasing the risk of morbidity and mortality in this patient population. It is the responsibility of healthcare providers to utilize all the multimodal tools in their armamentarium to provide effective pain relief without unintentionally facilitating substance abuse.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Washington University School of Medicine, 23 Bon Price Terrace, St. Louis, MO, 63132, USA

    Rahul Rastogi M.D.

  2. Department of Anesthesiology, Washington University School of Medicine, 1127 Terrace Drive, St. Louis, MO, 63117, USA

    Narendren Narayanasamy M.D.

  3. Spine & Sports Rehabilitation Institute, 2600 E. Southern Avenue, STE I-1, Tempe, AZ, 85282, USA

    Paul Sraow M.D., M.S.

Authors
  1. Rahul Rastogi M.D.
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  2. Narendren Narayanasamy M.D.
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  3. Paul Sraow M.D., M.S.
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Corresponding author

Correspondence to Rahul Rastogi M.D. .

Editor information

Editors and Affiliations

  1. Louisiana State University Health Sciences Center, Louisiana State University Interim Hospital, and Ochsner Kenner Hospital, Departments of Anesthesiology and Pharmacology, New Orleans, Louisiana, USA

    Alan David Kaye

  2. Department of Anesthesiology, Yale University School of Medicine and Yale-New Haven Hospital, New Haven, Connecticut, USA

    Nalini Vadivelu

  3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Richard D. Urman

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Rastogi, R., Narayanasamy, N., Sraow, P. (2015). Chronic Pain Patients and Substance Abuse. In: Kaye, A., Vadivelu, N., Urman, R. (eds) Substance Abuse. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1951-2_32

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  • DOI: https://doi.org/10.1007/978-1-4939-1951-2_32

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1950-5

  • Online ISBN: 978-1-4939-1951-2

  • eBook Packages: MedicineMedicine (R0)

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