Acute Pain Management for Patients on Medication-Assisted Treatment for Opioid-Use Disorder

2017 ◽  
Vol 33 (3) ◽  
pp. 1-10
Author(s):  
Elizabeth A. Mayerson ◽  
Thomas Julian
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Acute Pain Management ◽  
Medication Assisted Treatment

scholarly journals 102 A two-centre survey of caregiver perspectives on opioid use for children’s acute pain management

2019 ◽  
Vol 24 (Supplement_2) ◽  
pp. e39-e39
Author(s):  
Esther Jun ◽  
Samina Ali ◽  
Naveen Poonai ◽  
Maryna Yaskina ◽  
Amy Drendel ◽  
...  
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Opioid Use ◽  
Acute Pain Management

scholarly journals Acute pain management among patients with opioid maintenance therapy: specificities and difficulties identified in primary care: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e044433
Author(s):  
Morgane Guillou Landreat ◽  
Melia Baillot ◽  
Delphine Le Goff ◽  
Jean Yves Le Reste
Keyword(s):  
Primary Care ◽  
Pain Management ◽  
Qualitative Study ◽  
Medical Care ◽  
Thematic Analysis ◽  
Acute Pain ◽  
Sampling Strategy ◽  
Snowball Sampling ◽  
Opioid Use ◽  
Acute Pain Management

ObjectivesIn the last 30 years, opioid maintenance treatment prescription (OMT) has changed patients’ and also changed physicians’ practices. General practitioners (GPs) have to deal with patients on OMT who are in acute pain. The objective of this qualitative study was to explore medical care challenges and solutions identified by GPs in the management of acute pain among patients receiving OMT.Design and settingQualitative study with semistructured interviews were used as a data collection technique with a sampling strategy using a snowball sampling method to obtain a purposive sample of practicing GPs. Analysis was undertaken using a thematic analysis method.ParticipantsTwelve GPs, working in France (Brittany) who prescribe OMT were interviewed.ResultsThe thematic analysis resulted in two main themes relating to specificities and difficulties identified: (1) Medical care and training challenges identified by GPs treating patients on OMT with acute pain, with four subthemes : management of these situations not concerning primary care, lack of training prompts GPs to rely on peer and specialist support, lack of guidelines and conflicting recommendations between clinicians in different settings (2) linked to the patient–GP relationship, with six subthemes: Implementing an individualised centred approach, acute pain management during OMT relies on a relationship based on trust, GPs found difficulties in evaluating and treating pain, difficulties in care adherence, fear of patients destabilisation, fear of misuse and diversion.ConclusionThe complexity of acute pain and OMT entails significant challenges for clinicians and patients. In primary care, it is hard to achieve a balance between pain relief and opioid use disorder treatment, in a global patient-centred approach. Fear of misuse or diversion was not a important factor, except for patients not known to the practitioners, but GPs were concerned with the risks of patient destabilisation in situations of acute pain.

Acute Pain Management for Patients Receiving Medication-Assisted Therapy

2019 ◽  
Vol 30 (4) ◽  
pp. 335-342
Author(s):  
Peggy Compton
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Treatment ◽  
Management Strategies ◽  
Immediate Release ◽  
Opioid Use Disorder ◽  
Health Issues ◽  
Opioid Use ◽  
Opioid Medications ◽  
Analgesic Opioids

Evidence-based approaches for the treatment of opioid use disorder include the use of opioid medications (methadone, buprenorphine, or naltrexone), collectively referred to as medication-assisted therapy. Patients receiving medication-assisted therapy may present in the acute care setting with pain, often related to planned surgical procedures to treat health issues that were not addressed before entering treatment. Because these medications act on the same receptors as do analgesic opioids—and, in the cases of methadone and buprenorphine, have analgesic properties — managing acute pain in these patients can be challenging. Principles of effective pain management for these patients include continuing the usual medication-assisted therapy dose; using nonpharmacological and nonopioid pain management strategies as possible and immediate-release opioids, titrating to effect and monitoring for toxicity; anticipating tolerance and hyperalgesia; and establishing a collaborative treatment relationship with the medication-assisted therapy provider. Providing effective pain treatment supports ongoing recovery in patients with opioid use disorder.

Acute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations

2019 ◽  
Vol 85 (7) ◽  
Author(s):  
Theodosios Saranteas ◽  
Iosifina Koliantzaki ◽  
Olga Savvidou ◽  
Marina Tsoumpa ◽  
Georgia Eustathiou ◽  
...  
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Acute Pain ◽  
Ultrasound Guided ◽  
Acute Pain Management ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

Role of Paracetamol in Acute Pain Management

Drugs ◽  
2003 ◽  
Vol 63 (Special Issue 2) ◽  
pp. 15-21 ◽  
Author(s):  
Henrik Kehlet ◽  
Mads Utke Werner
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Acute Pain Management

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

scholarly journals Medically Treated Opioid Overdoses Among the U.S. Elderly: Trends and Correlates

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Peter Treitler ◽  
Stephen Crystal ◽  
Richard Hermida ◽  
Jennifer Miles
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
The Elderly ◽  
Opioid Use Disorder ◽  
Chronic Obstructive ◽  
Medicare Beneficiaries ◽  
Older Individuals ◽  
Opioid Use ◽  
Policy And Practice ◽  
Obstructive Pulmonary Disease

Abstract High rates of opioid prescribing and comorbid medical conditions increase risk of overdose among older adults. As the US population ages and the rates of opioid use disorder (OUD) increase in the elderly population, there is a need to characterize trends and correlates of overdose in order to more effectively target policy and practice. Using a ~40% random sample of 2015-2017 Medicare beneficiaries ages 65 and older with Part D pharmacy coverage, this study examined medically treated opioid overdoses among US older adults. The sample included 13-14 million beneficiaries per year. The rate of medically treated opioid overdoses among elderly Medicare beneficiaries increased by 15% from 6 per 10,000 in 2015 to 6.9 per 10,000 in 2017. Those with overdose were disproportionately female (63%), non-Hispanic white (83%), with diagnoses of pain conditions (96%), with diagnoses of major depression (63%), and with high rates of conditions that decrease respiratory reserve such as chronic obstructive pulmonary disease. 13% had co-occurring diagnosed alcohol use disorder, 36% were diagnosed with opioid dependence or abuse, and 12% were diagnosed with hepatitis C. Older individuals with overdose represent a complex mix of risk factors; identifying those most at risk (as well as those who have very low risk, whose pain management may be compromised by overly-rigid interpretation of opioid use guidelines) is key in order to address multiple risks, balancing risk reduction with appropriate pain management.

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