title: [Pain treatment in patients on chronic opioid therapy and in drug abusers].
abstract: BACKGROUND
  Substance abuse in pain management can undermine treatment compliance, the effectiveness of therapies, and social support and functioning.
  
  
  METHODS
  An overview is given regarding pain management for patients on chronic use of opioids and for patients with drug dependence and substance abuse.
  
  
  RESULTS
  Clinical experience as well as relevant documentation demonstrates that management of these patients remains one of the most challenging problems in clinical medicine.
  
  
  CONCLUSIONS
  Assessment and treatment plans for this patient group require an understanding of tolerance, physical dependence and drug abuse. It is imperative that the patient's ongoing treatment is planned in a multidisciplinary setting, so as to assure a consistent, structured and shared approach by all caregivers.
authors.affiliation: Anestesiavdelingen, Det Norske Radiumhospital, Montebello, 0310 Oslo. u.e.kongsgaard@klinmed.uio.no
authors.forename: Ulf E
authors.initials: UE
authors.lastname: Kongsgaard
authors.forename: Rae Frances
authors.initials: RF
authors.lastname: Bell
authors.forename: Harald
authors.initials: H
authors.lastname: Breivik
mesh_terms: D000208:Acute Disease; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D004361:Drug Tolerance; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010347:Patient Care Planning; D010349:Patient Compliance; D010353:Patient Education as Topic; D012307:Risk Factors; D012944:Social Support; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid