Knowledge Series III

Management of chronic pain is a complex affair. Assessment of pain and the risk of drug abuse, misuse, addiction, and diversion are essential in order to ensure the benefits of therapy outweigh the risks to achieve optimal outcomes. Effective  communication skills between patient and practitioner are required to maximize necessary interactions, such as deriving an accurate diagnosis, assessing risky substance-related behaviors, providing clear information with the goal of obtaining informed consent, discussing treatment plans and achieving mutual agreement towards treatment goals, monitoring and management of care, and discussion of conditions that surround discontinuation of treatment.

When the patient with chronic pain is diagnosed with a substance use disorder, the practitioner needs to know how to balance pain management with treatment of the substance use disorder and/or addiction. A step-wise strategic approach is suggested to manage this medical challenge. Addiction is still misconstrued by some medical professionals as a condition involving loss of moral integrity. Recent advances in neuro and molecular imaging have demonstrated that addiction is a neurologic, genetic, environmental, and behavioral medical disease, without known cure. Both chronic pain and addiction are diseases that require longitudinal care. Knowledge of best-practice care and referral for patients with addiction is a critical component of positive-outcome management.

Several initiatives have been developed and were designed to minimize drug misuse, abuse, and limit addiction and diversion of drugs. One such initiative is electronic prescription monitoring, a national program, with a focus to control risk associated with prescribed controlled substances. The program is fraught with controversy and it is recommended that origination of electronic prescription monitoring reports needs to be considered on a case-by-case basis.  

Emerging Solutions in Pain is pleased to offer Knowledge Series III, a set of four monographs developed to highlight and discuss these important issues in chronic pain and addiction management.

Electronic Prescription Monitoring Programs: A Data-Reporting Tool Designed to Prevent Drug Diversion
David B. Brushwood, RPh, JD
Release Date: October 01, 2007
Expiration Date: October 01, 2010
Professor Brushwood provides a clear and concise update on electronic prescription monitoring and provides case studies that highlight the relevancy of its use in patient management.
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Neuroimaging: Interpreting Addiction
David Schlyer, PhD
David Schlyer, PhD, a senior research scientist at Brookhaven Laboratories, offers expert insight as to how molecular imaging has provided new information about the disease of addiction.
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Patient and Clinician: Mutual Shareholders in the Treatment of Chronic Pain
April Hazard Vallerand, PhD, RN, FAAN
Release Date: August 01, 2007
Expiration Date: August 01, 2010
Patient-clinician communications needed for effective pain control and applications of strategies promoting optimal communications are discussed.
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Treating Chronic Pain in the Shadow of Addiction
Penelope P. Ziegler, MD, FASAM
Release Date: February 09, 2007
Expiration Date: February 09, 2010
Dr. Penelope Ziegler, an addiction specialist from Virginia, offers a strategic approach to the longitudinal care of patients with concomitant chronic pain and substance use disorders, especially those with addiction.
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