About Physiatry

Opioid Management for Chronic Pain

Condition: Opioids are drugs that help relieve chronic and acute pain. An example of an opioid is morphine.

Background: Opioids are powerful and can help patients with severe pain. However, there is much confusing media coverage regarding opioid use and addiction. Because of this, people are sometimes hesitant to use them. As a result, pain can be undertreated or people may be stigmatized for using opioids.

Risk Factors: People more at risk for abusing opioids include those who have had previous substance or alcohol abuse issues, depression, anxiety, and people who have used opioids at the same time as tranquilizers.

History and Symptoms: The term “pseudo-addiction” is used with people who are undertreated. Because they have severe pain and their prescription is not bringing relief, they may take more medication than prescribed, run out early, or experience withdrawal. Usually these symptoms are eliminated after proper medication adjustments are made. Addiction is different—it is a disease where people crave opioids and use them compulsively.

Physical Exam: Every patient’s pain experience is unique. Therefore, the physical exam and decision to prescribe opioids can vary.

Diagnostic Process: In the U.S., 10% of the population experiences chronic pain. Additionally, between 3% and 16% have substance abuse issues. A physician must carefully assess a patient’s pain and risk factors in order to determine the best pain management options.

Rehab Management: An effective pain management program is based on quality patient-physician communication. If the patient feels the opioid is not helping, he or she must tell the physician so a better solution can be found, instead of taking more medication.

Other Resources for Patients and Families: Families and patients should learn about substance abuse as well as how proper opioid use can improve quality of life. Learn more at the National Institute of Health’s Pain Consortium.


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