Managing Pain in Patients With An Addiction History

Janice F. Kauffman, RN, MPH, LADC, CAS
Vice President, Addiction Treatment Services
North Charles Foundation, Inc.
Assistant Professor of Psychiatry
Harvard Medical School
May 13, 2014

Chronic pain affects over 100 million American adults, more than the total affected by heart disease, cancer and diabetes combined. Estimates of addiction among chronic pain patients vary widely because of insufficient research on long-term outcomes, differences in treatment duration; disparate study populations and measures are used to assess abuse or addiction. Currently, 40% of opioid prescriptions are written by general or family practitioners, osteopaths, or internists, yet few have had training about the safe management of chronic pain patients. To insure that physicians prescribe safely and effectively for the appropriate patients and indications requires training, monitoring and support. A comprehensive multidisciplinary and collaborative approach and access to data sources (e.g. Prescription Drug Monitoring Programs) are among the valuable components to enhance the safe and effective treatment for chronic pain patients.    
The goal of this presentation is to familiarize clinicians with the tools to identify chronic pain patients at risk for misuse of opioids, and provide strategies for managing chronic pain patients with addictive disorders. Guidelines for risk stratification, safe prescribing, and assessing, monitoring and managing aberrant behavior will be discussed.