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

http://www.theapms.com/sitePagesContent/stephens-docs/SuboxoneInfoStephens.pdf

 

ASAM Definition of Addiction

https://www.naabt.org/documents/APS_consensus_document.pdf

 

Acute Pain Management for Patients Receiving Maintenance Methadone or Buprenorphine Therapy

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892816

 

Acute & Chronic Pain Management (requiring opioid analgesics) in Patients Receiving Pharmacotherapy for Opioid Addiction

http://www.thci.org/Opioid/June11docs/Session8_ALFORD%20MAT%20pain%20management%206-9-11%20FINAL.pdf

 

Clinical Opiate Withdrawal Scale

https://www.drugabuse.gov/sites/default/files/files/ClinicalOpiateWithdrawalScale.pdf

 

Perioperative Pain Management for Patients on Chronic Buprenorphine: A Case Report

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846172/

 

Methadone Dose Conversion Guidelines Adapted from AAHPM Palliative Care Primer, 2010 edition with permission from Timothy Quill M.D.

http://www.compassionandsupport.org/pdfs/professionals/pain/Methadone_Dose_Conversion_Guidelines.051810_.pdf

 

Buprenorphine Hydrochloride Injection

http://www.hospira.com/en/images/EN-2088_tcm81-5649.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892816/

 

http://www.theapms.com/sitePagesContent/stephens-docs/SuboxoneInfoStephens.pdf

 

http://buprenorphine.samhsa.gov/Bup_Guidelines.pdf

 

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