General Principles
- Comprehensive assessment of pain
- Clear communicaiton between all team members, including the patient/family
- Follow relevant pharmacologic principles
- Understand tolerance issues
- Investigate and clarify problematic behavior and difficulty progressing care
- Consider multidisciplinary consultation (mental health, addiciton, pain, social work, spiritual care, etc.)
Reference
Laroche F, Rostaing S, Aubrun F, Perrot S. Pain management in heroin and cocaine users. Joint Bone Spine 2012;79(5). PMID:22405747 DOI:10.1016/j.jbspin.2012.01.007
Paschkis Z, Potter ML, CE: Acute pain management for inpatients with opioid use disorder. Am J Nurs 2015;115(9). PMID:26273927 DOI:10.1097/01.NAJ.0000471243.30951.92
Stromer W, Michaeli K, Sandner-Kiesling A. Perioperative pain therapy in opioid abuse, Eur J Anaesthesiol 2013;30(2). PMID: 23241915 DOI:10.1097/EJA.0b013e32835b822b
Eric's Hospital Experience
The following video describes why Eric's hospital experience was "unwilling," along with why he felt "ashamed and guilty," and finally, why pain control efforts were ineffective.
Eric's Relapse
The following video describes why the inpatient program for rehabilitation from substance use wasn't for Eric, how he relapsed after his hospital admission, and why he needed to be ready for treatment.
Additional Resources for Communication and Care Planning
To learn more about:
- How to assess stage of readiness to change
- Using opioids for acute pain in patients with OUD
- Addiction maintenance therapy
- Substance use in hospital
- Care coordination at hospital discharge
- Naloxone prescription for potential outpatient opioid overdose
- Patients likely to go back to using heroin
Click the "Communication and Care Planning" tab.