Pain Management for Patients With Opioid Use Disorders

As the prevalence of opioid use disorder (OUD) continues to rise, it is crucial clinicians are prepared to deliver safe and effective therapy to individuals affected by this disorder. The occurrence of pain among patients with OUD is not uncommon; effective management is complex and requires a comprehensive approach developed in collaboration with patients, their families and specialists in substance use disorders. Most patients with OUD require long-term treatment. For many, this involves chronic medications including buprenorphine, methadone or naltrexone. First-line pain management therapy with nonpharmacologic or non-opioid pharmacotherapy, including multimodal strategies should be maximized first and tailored to underlying pain etiology. In some settings, patients may require additional opioid medications for pain control. In this review, we describe an approach to pain management in patients receiving medications for OUD as well as those with untreated OUD.