Educational Activities Archives

The current opioid and drug overdose crisis continues to have a devastating impact on morbidity and mortality in the United States. With the rise in use of potent synthetic opioids like fentanyl in the drug supply, creating linkages to comprehensive substance use related services is critical. Opioid Treatment Programs (OTP) and the comprehensive care and services they provide play a vital role in addressing this need, yet challenges remain. Despite clear evidence of the benefits of OTP’s, access to OTPs in some parts of the country is limited; stigma related to the use of methadone remains a challenge. Yet in the face of these headwinds, many OTPs are providing comprehensive leading-edge services to address the opioid and drug overdose crisis.

Assessing and managing pain while evaluating risks associated with substance use and substance use disorders continues to be a challenge faced by health care clinicians. The American Society for Pain Management Nursing and the International Nurses Society on Addictions uphold the principle that all persons with co-occurring pain and substance use or substance use disorders have the right to be treated with dignity and respect, and receive evidence-based, high quality assessment, and management for both conditions. The updated position statement and practice recommendations will be discussed to guide care of all patients and those with SUD increased risk.

Over 40% of the U.S. infantry reported chronic pain (defined as pain lasting over 3 months) after deployment, and 15% reported opioid use in the past month. [1] Like the civilian population, prescription opioid misuse is a concern for military personnel. The military has responded to this issue by implementing medication treatment for opioid use disorder (MOUD) in VA facilities. Historically, MOUD at the VA has been prescribed only through substance use disorder clinics and did not reach Veterans who were not seen in these clinics.

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The Pain Medication Questionnaire (PMQ) was designed to assess the risk for opioid medication misuse in chronic pain patients. A preliminary study showed a positive relationship between higher PMQ scores and concurrent measures of substance abuse, psychopathology, and physical/ life-functioning. Using a larger sample size, the present study sought to replicate these findings, and to expand upon them by examining the relationship between PMQ scores and various treatment outcomes.

“Intersection of Pain and Addiction” was written by Daniel Alford, MD, MPH, Professor of Medicine at Boston University School of Medicine; and Director of the Clinical Addiction Research and Education Unit at Boston Medical Center’s Grayken Center for Addiction.