The current opioid crisis, partly fueled by the excess availability of prescription opioids for pain management, has highlighted the enormous challenge of managing disabling chronic pain intertwined with physiologic dependence to medications and substance use disorders (SUDs) and other medical and psychiatric disorders. Clinicians evaluating patients with the dual problem of pain and addiction often face the question, “Is this pain or is this addiction?” However, constricted focus on chronic pain and SUD as separate treatment entities often misses the complexity of the whole individual who suffers from the two maladies. These patients also may have high psychiatric and medical illness burden, as well as use multiple substances or medications to manage their symptoms. These coexisting, multiple problems interact with each other and pain and addiction in complex ways (multimorbidity), making clinical management challenging. In a nutshell, the problem of “pain and addiction” is more than the sum of its parts, and thus necessitates an integrated, multi-dimensional therapeutic approach. However, there is a lack of simple heuristic frameworks to manage patients with the complex condition of “pain and addiction," especially in low-resource settings. The short supply of specialists and programs in this area will likely force many health care systems to build primary care-based programs adapted to local resources. This session will describe an integrative, multi-dimensional pharmacobehavioral model to manage these complex, commonly co-occurring conditions, and enable participants to develop pain and addiction programs in low resource settings.
This session is accredited for the following accreditation types: CME, CNE, CPE, APA, AAFP, AAHCPAD*, NAADAC*, ASWB*
*State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit.