title: Chronic pain in patients with substance abuse disorder: general guidelines and an approach to treatment.
abstract: Treating pain may be difficult in patients with a coexisting substance abuse disorder. Opioids can be used successfully to control pain in such a patient population, but the physician must have a general understanding of addictive behavior and early signs of abuse. The challenge is not in treating pain, but identifying true pain from drug-seeking behaviors. Furthermore, several myths of opioid usage, such as iatrogenic addiction and risk of disciplinary action, may be unfounded. General guidelines and open communication between patient and physician may aid in controlling pain. With better understanding and a systematic treatment approach, patients with substance abuse disorders can receive adequate symptomatic pain relief.
authors.affiliation: Section of General Internal Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX 77030, USA. adam.mitchell@bcm.tmc.edu
authors.forename: Adam M
authors.initials: AM
authors.lastname: Mitchell
authors.forename: Charlene M
authors.initials: CM
authors.lastname: Dewey
mesh_terms: D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D008691:Methadone / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology
chemical_list: D008691:Methadone