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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Pain Management and Substance Use Disorders: A Position Statement.

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    Individuals with co-occurring pain and substance use disorder deserve respectful, evidence-based care for both conditions. An integrated approach, prioritizing non-pharmacological methods and team-based specialists, is recommended for optimal management.

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    Area of Science:

    • Nursing
    • Addiction Medicine
    • Pain Management

    Background:

    • Co-occurring pain and substance use disorder (SUD) present complex challenges in patient care.
    • Current approaches may not adequately address the integrated needs of these patients.
    • Professional organizations advocate for improved standards in managing these dual conditions.

    Purpose of the Study:

    • To outline a position statement for the integrated assessment and management of patients with co-occurring pain and substance use disorder.
    • To emphasize the right of these patients to dignified and evidence-based care.
    • To recommend specific strategies for effective pain and addiction management.

    Main Methods:

    • Development of a position statement by professional nursing organizations.
    • Review and synthesis of evidence regarding integrated care models.
    • Formulation of recommendations for clinical practice and institutional policies.

    Main Results:

    • Advocacy for treating patients with co-occurring pain and SUD with dignity and respect.
    • Recommendation of an integrated, holistic, and multidimensional approach to care.
    • Emphasis on nonopioid and nonpharmacological pain management strategies, with judicious use of opioids when necessary.
    • Promotion of team-based care involving pain and addiction specialists.
    • Inclusion of relapse prevention and patient/support person involvement in care plans.

    Conclusions:

    • Integrated care is essential for patients with co-occurring pain and substance use disorder.
    • Healthcare institutions must develop supportive policies and procedures.
    • A multidisciplinary, patient-centered approach ensures high-quality management of both conditions.