title: Managing acute and chronic pain in a substance abuse treatment program for the addicted individual early in recovery: a current controversy.
abstract: Patients early in recovery from addictive disorders are in a tenuous position and when these individuals are stressed from acute or chronic pain they face even more challenges. Physicians are often conflicted by the desire to help the patient achieve pain control and maintain sobriety. While there have been a handful of studies examining patients in either active addiction with pain or with a more remote history of addiction with pain, there have been very few, if any, that look at treating patients during their addiction recovery process who suffer from pain. This article will examine the issue of whether it is ever appropriate to use opioid pain medications on such patients and, if so, what guidelines can be used to maximize the chances of a good outcome while minimizing the chances of causing a recurrence or exacerbation of addiction.
authors.affiliation: Alcohol and Drug Abuse Treatment Program, James A. Haley Veterans Administration Health Care System, 13000 Bruce B. Downs Boulevard, Tampa, Florida 33612, USA. JoeMark11@aol.com
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Markowitz
authors.forename: Elie M
authors.initials: EM
authors.lastname: Francis
authors.forename: Cheryl
authors.initials: C
authors.lastname: Gonzales-Nolas
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D019966:Substance-Related Disorders / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome