Cover

Chronic Pain and Addiction

Editor(s): Clark M.R. (Baltimore, Md.) 
Treisman G.J. (Baltimore, Md.) 
Table of Contents
Vol. 30, 2011
Section title: Paper
Clark MR, Treisman GJ (eds): Chronic Pain and Addiction. Adv Psychosom Med. Basel, Karger, 2011, vol 30, pp 92–112
(DOI:10.1159/000324068)

Optimizing Treatment with Opioids and Beyond

Clark M.R. · Treisman G.J.
Departments of aPsychiatry and Behavioral Sciences and bMedicine, The Johns Hopkins University School of Medicine, and cChronic Pain Treatment Program and dAIDS Psychiatry Service, The Johns Hopkins Medical Institutions, Baltimore, Md., USA

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 4/19/2011
Cover Date: 2011

Number of Print Pages: 21
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-9725-8 (Print)
eISBN: 978-3-8055-9726-5 (Online)

Abstract

Patients with both chronic pain and substance use disorders offer special challenges and opportunities. They represent a large number of patients with significant costs to themselves and society that translate into poor outcome. The challenges in defining addiction in patients with chronic pain, particularly in those treated with chronic opioid therapy, have distracted the healthcare community from designing effective treatment programs. Traditional treatment programs for chronic pain disorders or substance use disorders are incapable of addressing the issues of the patients’ ‘other’ problem. Treatment devolves to prescribing opioid medications with the belief that both disorders will be treated at least in part, which is deemed better than receiving no treatment at all. Patients are actually concerned about the risks of this type of treatment, and even if it did offer significant benefits, physicians demonstrate a lack of knowledge and skill in administering opioids to these patients. The inadequate treatment of either chronic pain or addiction interferes with the treatment of the other condition and necessitates the design of new treatment paradigms. A new approach to patients with both chronic pain and addiction should start with an evaluation and formulation of these patients to determine the different domains that contribute to their disability (diseases, dimensions, behaviors, life stories). A comprehensive formulation provides the appropriate platform for the implementation of an integrated program of therapy for both conditions that can be intensified to provide more, rather than less, care for the patient that does not meet the goals of functional rehabilitation.


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 4/19/2011
Cover Date: 2011

Number of Print Pages: 21
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-9725-8 (Print)
eISBN: 978-3-8055-9726-5 (Online)


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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