[Acute pain management in opioid-maintained patients]

Treatment of acute nociceptive pain in patients with opioid substitution therapy (OST) is an actual topic. The clinical features of this population, as pain sensibility, and the pharmacological features of OST, require an individualized care which must be adjusted to the patient's pain and the OST used. This article offers a summary of the main possible pharmacological strategies by highlighting the features of pain in these patients and removing the barriers to an effective management. Generally, the OST is kept and a multimodal analgesia is added according to the intensity of the pain. Multimodal analgesia includes non pharmacological measures, non opioid drugs and/or opioid drugs which must be chosen according to the OST. Collaboration between different health professionals provides an effective management of pain in order to protect this vulnerable population from the negative health consequences of an insufficiently relieved pain.