Treating Comorbid Opioid Use Disorder in Chronic Pain

ISBN-13: 9783319298610 / Angielski / Miękka / 2016 / 237 str.

Annette M. Matthews; Jonathan C. Fellers

Opis

​This in-depth text addresses how to approach and treat the chronic pain patient struggling with problematic opioid use. It discusses the approach for patients who may be at high risk of problematic use, such as those with a history of mental illness or substance use disorder. The first part covers diagnosis and treatment, focusing on common best practices that practitioners can adapt to any practice. Two of the chapters detail alternative and replacement therapies for opioid. Two more cover special issues in the treatment of women and older patients. The second part reviews the ethical, legal, regulatory, and policy issues surrounding the treatment of patients with comorbid pain and addiction. The book includes strategies for documentation that mitigate the risk of legal issues or ethical boundary crossings. The last part of the book addresses treating comorbid pain and opioid use disorder in different medical settings and the treatment of co-occurring mental illnesses and substance abuse. Treating Comorbid Opioid Use Disorder in Chronic Pain is of great value to psychiatrists, pain physicians, primary care providers, social workers, drug rehabilitation centers, and other behavioral health professionals. ​

Spis treści

Introduction (Annette m. Matthews, MD, and Johnathan Fellers, MD; OHSU)

Part I. Diagnosis and Treatment

• Epidemiology of Pain and Opiate Addiction (Maria A. Sullivan, M.D., Ph.D; NYSPI)

1. Theories of Pain and Addiction: Type of Pain, Pathways to Opiate Addiction (Johnathan Fellers, MD; OHSU)

2. Types of Problematic Opiate Use and How to Detect Them (Annette M. Matthews, MD; OHSU) <

3. Pharmacology of Pain Treatment: Opiates and Other Allopathic Treatments (Thomas Carr, MD; PVAMC)

4. Alternative Treatments (Laura Baum, PhD; UVA)

5. Evaluation the Bio-Psycho-Social Milieu of Pain (Ben Morasco, PhD, Steve Dobscha, MD; OHSU)

6. Clinical Measurement of Pain, Opiate Addiction and Functional Status (Veronica Rodriguez, PhD; PVAMC) 

7. Methadone and Buprenorphine: The place of Opiate Replacement Therapies (Andrew J. Saxon, MD; UW) 

8. Procedures, Devices, Ablations, Surgeries (Andrew Engel, MD; OHSU)

9. Special Issues in the Treatment of Women (Anushka Shenoy, Stacy Gramann, MD; OHSU). 

10. Special Issues in the Treatment of Older Patients (Meridith Lee, DO; UVA, and Suzanne Holroyd MD; West Virginia) 

11. Recovery: What does it look like?  (Marv Seppala, MD, Laura Ferguson, MD; Hazelden Springbrook) 

Part II. Ethical, Legal, Regulatory, and Policy Issues

1. History of Opiate Prescribing and Opiate Related Drug Laws (Edward Michiana, JD, MD; Harvard) 

2. Developing Facility Responses: Opiate Treatment Improvement Committee (Thomas Carr, MD; PVAMC) 

3. Diversion and Abuse: pain contracts, urine drug screens, pill counts, visit frequency 

(Micheal H. Gendel, MD; Private Practice, Colorado) 

4. Prescription monitoring programs (Johnathan Fellers, MD; OHSU) 

5. Documentation of Treatment, Treatment Plan, and Informed Consent  (Donna Chen, MPH, MD; UVA) 

6. Emotional vs. Science Driven Treatment: The case of chronic low back pain (Rodger Chou, MD; OHSU) 

7. Federal involvement in pain management policy: SAMHSA, CDC, DEA, ONDC, NIDA, US FDA (H. Westley Clark, MD, JD, MPH; CSAT) 

Part III. Best Practices and Practice Models

1. Multidisciplinary Pain Clinics (Travis Lovejoy, PhD; PVAMC) 

2. The Role of the Emergency Room in Chronic Pain Treatment (Knox H. Todd, MD, MPH; UofT MD Anderson) 

3. Assessing and Treating Co-Occurring Mental Illness (Richard Rosenthal, MD; Columbia)

4. Assessing and Treating Other Co-Occurring Substance Abuse (Jyothsna Wudali, MD; Susan Whitley, MD; SUNY Downstate) 

Appendix I. Resources

O autorze

Annette M. Matthews, MD Associate Professor Department of Psychiatry & Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University Portland, OR, USA; Staff Psychiatrist Portland VA Medical Center Portland, OR, USA 

Jonathan C. Fellers, MD Substance Abuse Clerkship Director, PGY-3 Psychiatry Residents Department of Psychiatry Oregon Health & Science University Portland, OR, USA; Mental Illness Research Education Clinical, Centers of Excellence Portland VA Medical Center Portland, OR, USA

Blurb

​This in-depth text addresses how to approach and treat the chronic pain patient struggling with problematic opiate use.  It discusses the approach for patients who may be at high risk of problematic use, such as those with a history of mental illness or substance use disorder. The first part covers diagnosis and treatment, focusing on common best practices that practitioners can adapt to any practice. Two of the chapters detail alternative and replacement therapies for opiates. Two more cover special issues in the treatment of women and older patients.  The second part reviews the ethical, legal, regulatory, and policy issues surrounding the treatment of patients with comorbid pain and addiction. The book includes strategies for documentation that mitigate the risk of legal issues or ethical boundary crossings. The last part of the book addresses treating comorbid pain and opiate abuse in different medical settings and the treatment of co-occurring mental illnesses and substance abuse. 

Treating Comorbid Opioid Addiction and Dependence in Chronic Pain is of great value to psychiatrists, pain physicians, primary care providers, social workers, drug rehabilitation centers, and other behavioral health professionals.  ​