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Thursday, April 24, 2014
Pain Management and Intravenous Drugs
how do you treat a patient that is well known to be a drug seeker? How about the intravenous drugs, while admitted to the hospital for pain? What is your recommendation with regard to their treatment with narcotics, if they you've already tried non-narcotics?
In any patient with addiction or dependence issues, an "Addiction Medicine" or psychiatric consult is in order even in the presence of legitimate cause for pain such as surgery. IV drugs should be used to treat painful conditions (such as post-surgical pain) if indicated in admitted patients who are known substance abusers or drug seekers. For outpatient management, no narcotics are advised without the involvement of an addiction specialist and patient enrollment in a pain program.
Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University