Topical Concurrent Session 2E – Managing pain in the patient with an addiction disorder
Managing pain in the patient with an addiction disorder
Chair: Professor Pam Macintyre, Royal Adelaide Hospital, SA
When acute, cancer or chronic non-cancer pain occurs in a patient who has an addiction to opioids or other substances, its management can present a complex clinical challenge to the health care provider(s) and also act as a source of frustration and sometimes anger for the patient. When it comes to effective management of pain, it is an addiction to opioids that impacts most on effective pain treatment. In part this will be because the patients taking long-term opioids will be tolerant to the effects of the drug and have become physically dependent on it. However, the pattern of behaviours and psychological traits that are associated with addiction, especially in patients with a dual diagnosis (psychiatric comorbidity and addiction) as well as some of the legislative requirements surrounding the prescribing of opioids in most jurisdictions, can also impact significantly on treatment strategies. This workshop will look at management of pain in the inpatient setting, often relatively straight forward, and then management in the community, which can be more problematic. In both settings, an understanding of possible treatment options is required, an assessment of the effectiveness and outcomes of pain treatments is important, and there needs to be an understanding of how potential risk can be evaluated and managed.
Dr Victoria Cock, Drug and Alcohol Services of South Australia, SA
Dr Meredith Craigie, Royal Adelaide Hospital, SA
Dr Will Liaw, University of Adelaide, SA