Patients benefitting from the therapeutic effects of chronic opioid therapy generally fall into two categories: (1) chronic pain treatment and (2) addiction “medication assisted treatment.” Both groups will at times need additional pain care measures to address acute issues, such as: trauma, surgery, and hospitalizations. Care providers, in trying to find the right balance between too much and too little, can find these situations challenging.
Today (December 1, 2015) I am traveling to Leitchfield, Kentucky to conduct a seminar at Twin Lakes Regional Medical Center on acute pain management for the patient on chronic opioid therapy. Below are the slides that I prepared, followed by the references. My hope is that, whether you are a healthcare provider or recipient, as you peruse this information and explore the references and links a better understanding will emerge and your comfort level will improve.
Guidelines for Perioperative Management of Buprenorphine
ASAM Definition of Addiction
Acute Pain Management for Patients Receiving Maintenance Methadone or Buprenorphine Therapy
Acute & Chronic Pain Management (requiring opioid analgesics) in Patients Receiving Pharmacotherapy for Opioid Addiction
Clinical Opiate Withdrawal Scale
Perioperative Pain Management for Patients on Chronic Buprenorphine: A Case Report
Methadone Dose Conversion Guidelines Adapted from AAHPM Palliative Care Primer, 2010 edition with permission from Timothy Quill M.D.
Buprenorphine Hydrochloride Injection