Journal of opioid management
-
Opioid analgesics are commonly used to manage moderate to severe pain. However, the long-term use of opioids could lead to opioid tolerance (OT) and opioid-induced hyperalgesia (OIH). Distinguishing OIH from OT would impact the practice of opioid therapy because opioid dose adjustment may differentially influence OT and OIH. ⋯ A key difference in clinical outcome is that OT and OIH could be improved and exacerbated by opioid dose escalation, respectively. Our survey results revealed a significant knowledge gap in some responders regarding differential diagnosis and management of OT and OIH. The results also identified several issues, such as opioid dose adjustment and clinical comorbidities related to OT and OIH, which require future patient-based studies.
-
Patients with substance use disorders can present challenges for effective perioperative pain management. Healthcare professionals with substance abuse disorders requiring medical treatment and pain management represent a unique subpopulation. ⋯ Although the incidence of substance use disorders in healthcare professionals is thought to be equivalent to the general population, the presentation, substances of choice, and inciting factors are unique. Further, treatment options available to such individuals have been established and proven successful.