Recommendations for Substance Abuse and Pain Control in Patients with Chronic Pain

In the present investigation, current literature on the relationship between substance abuse and pain is evaluated in order to improve clinical management and its implications on the increasingly challenging chronic pain and substance abuse epidemic. The relationship between substance abuse and chronic pain are evaluated, and this review provides recommendations on the management of this special patient population.

Currently, there are limited guidelines for prescribing opioids and other analgesics in the chronic pain population. As this field of practice continues to evolve, it is essential for clinicians to serve as the gatekeepers to monitor for misuse and safety. Multiple studies have indicated that illicit drug use and opioid abuse affect over 9% of patients. Although there are numerous reasons for seeking illicit drugs and abusing them, it is essential that clinicians identify factors which place certain patients at high risk and accordingly, to screen these patients in order to optimize their management. The high prevalence of patients with chronic pain who also screen positive for drug use emphasizes the importance and increasingly pressing need to evaluate and to manage chronic pain in this population.