Treating Comorbid Opioid Use Disorder in Chronic Pain

This in-depth text addresses how to approach and treat the chronic pain patient struggling with problematic opioid use. It discusses the approach for patients who may be at high risk of problematic use, such as those with a history of mental illness or substance use disorder. The first part covers diagnosis and treatment, focusing on common best practices that practitioners can adapt to any practice. Two of the chapters detail alternative and replacement therapies for opioid. Two more cover special issues in the treatment of women and older patients. The second part reviews the ethical, legal, regulatory, and policy issues surrounding the treatment of patients with comorbid pain and addiction. The book includes strategies for documentation that mitigate the risk of legal issues or ethical boundary crossings. The last part of the book addresses treating comorbid pain and opioid use disorder in different medical settings and the treatment of co-occurring mental illnessesand substance abuse.

Treating Comorbid Opioid Use Disorder in Chronic Pain ** is of great value to psychiatrists, pain physicians, primary care providers, social workers, drug rehabilitation centers, and other behavioral health professionals.

Reviews ethical, legal, regulatory, and policy issues that can affect approaches to chronic pain Presents successful models of chronic pain treatment as well as best practices Includes strategies for documenting patient care to mitigate risk of legal issues Offers alternative treatments and replacement therapies for opioid use Addresses special issues for women and elderly? Includes supplementary material: sn.pub/extras

Autorentext
Annette M. Matthews, MD Associate Professor Department of Psychiatry & Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University Portland, OR, USA; Staff Psychiatrist Portland VA Medical Center Portland, OR, USA
Jonathan C. Fellers, MD Substance Abuse Clerkship Director, PGY-3 Psychiatry Residents Department of Psychiatry Oregon Health & Science University Portland, OR, USA; Mental Illness Research Education Clinical, Centers of Excellence Portland VA Medical Center Portland, OR, USA

Inhalt

1. Introduction.- Part I. Diagnosis and Treatment.- 2. Epidemiology of Pain and Opiate Addiction.- 3. Theories of Pain and Addiction: Type of Pain, Pathways to Opiate Addiction.- 4. Types of Problematic Opiate Use and How to Detect Them.- 5. Pharmacology of Pain Treatment: Opiates and Other Allopathic Treatments.- 6. Alternative Treatments.- 7. Evaluation the Bio-Psycho-Social Milieu of Pain.- 8. Clinical Measurement of Pain, Opiate Addiction and Functional Status.- 9. Methadone and Buprenorphine: The place of Opiate Replacement Therapies.- 10. Procedures, Devices, Ablations, Surgeries.- 11. Special Issues in the Treatment of Women.- 12. Special Issues in the Treatment of Older Patients.- 13. Recovery: What does it look like?.- Part II. Ethical, Legal, Regulatory, and Policy Issues.- 14. History of Opiate Prescribing and Opiate Related Drug Laws.- 15. Developing Facility Responses: Opiate Treatment Improvement Committee.- 16. Diversion and Abuse: pain contracts, urine drug screens, pill counts, visit frequency.- 17. Prescription monitoring programs.- 18. Documentation of Treatment, Treatment Plan, and Informed Consent.- 19. Emotional vs. Science Driven Treatment: The case of chronic low back pain.- 20. Federal involvement in pain management policy: SAMHSA, CDC, DEA, ONDC, NIDA, US FDA Part III. Best Practices and Practice Models.- 21. Multidisciplinary Pain Clinics.- 22. The Role of the Emergency Room in Chronic Pain Treatment.- 23. Assessing and Treating Co-Occurring Mental Illness.- 24. Assessing and Treating Other Co-Occurring Substance Abuse.- Appendix I. Resources.