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Management of Chronic Pain in Hospitalized Patients with a History of Substance Abuse 

Management of Chronic Pain in Hospitalized Patients with a History of Substance Abuse
Chapter:
Management of Chronic Pain in Hospitalized Patients with a History of Substance Abuse
Author(s):

Eman Nada

, Nicole Labor

, and Dmitri Souzdalnitski

DOI:
10.1093/med/9780199349302.003.0022
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date: 18 October 2019

Abstract: This chapter highlights the specifics of managing chronic pain in patients with a history of substance abuse who are admitted to the hospital. Patient safety may be compromised because of known interactions between substances abused and some pain medications. In addition, a number of medications used for pain control have potential for abuse. The strategies for helping these patients without compromising their safety and while preserving their rights and autonomy depend on their stage of addiction (current addict, on replacement/maintenance, remote drug abuse). Current drug abusers may be tolerant to opioid medication, while those on a treatment regimen can be on multiple medications that make subsequent treatment difficult. Treating a patient with former abuse may result in relapse. It is important to obtain a good history in which the patient is specifically asked about prior substance abuse and/or its treatment. If the patient has a history of substance abuse but is currently abstinent, it is incumbent upon the practitioner to obtain further information about the level of recovery.

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