title: Effect of acute and chronic alcohol abuse on pain management in a trauma center.
abstract: The proper management of acute pain has been identified as a primary indicator of quality assurance in US trauma centers. Nearly half of all trauma patients are injured while intoxicated and 75% of these patients have chronic alcohol problems. The management of pain caused by injuries in patients with alcohol problems poses unique challenges. Biases exist regarding the crosstolerance effects of ethanol and opioids and the pain thresholds of patients with substance abuse histories. The purpose of this review is to examine some of the factors that inform our decisions of how to manage acute pain in this population and to review the empirical evidence that exists.
authors.affiliation: University of Washington School of Medicine, Department of Rehabilitation Medicine, Harborview Medical Center, 325 Ninth Avenue, Box 359740, Seattle, WA 98104, USA. wiechman@u.washington.edu
authors.forename: Shelley Wiechman
authors.initials: SW
authors.lastname: Askay
authors.forename: Charles H
authors.initials: CH
authors.lastname: Bombardier
authors.forename: David R
authors.initials: DR
authors.lastname: Patterson
mesh_terms: D000437:Alcoholism / Q000150:complications*; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications* / Q000188:drug therapy
chemical_list: D000700:Analgesics