Main description:

This in-depth text addresses
how to approach and treat the chronic pain patient struggling with problematic
opioid use. It discusses the approach for patients who may be at high
risk of problematic use, such as those with a history of mental illness or
substance use disorder. The first part covers diagnosis and treatment, focusing
on common best practices that practitioners can adapt to any practice. Two of
the chapters detail alternative and replacement therapies for opioid. Two more
cover special issues in the treatment of women and older patients. The
second part reviews the ethical, legal, regulatory, and policy issues
surrounding the treatment of patients with comorbid pain and addiction. The
book includes strategies for documentation that mitigate the risk of legal
issues or ethical boundary crossings. The last part of the book addresses
treating comorbid pain and opioid use disorder in different medical settings and the
treatment of co-occurring mental illnesses and substance abuse.

Treating Comorbid Opioid Use Disorder in Chronic
Pain is of great value to psychiatrists, pain
physicians, primary care providers, social workers, drug rehabilitation
centers, and other behavioral health professionals.

Contents:

Introduction (Annette m. Matthews, MD, and Johnathan Fellers, MD; OHSU)
Part I. Diagnosis and Treatment* Epidemiology of Pain and Opiate Addiction (Maria A. Sullivan, M.D., Ph.D; NYSPI)1. Theories of Pain and Addiction: Type of Pain, Pathways to Opiate Addiction (Johnathan Fellers, MD; OHSU)2. Types of Problematic Opiate Use and How to Detect Them (Annette M. Matthews, MD; OHSU) <3. Pharmacology of Pain Treatment: Opiates and Other Allopathic Treatments (Thomas Carr, MD; PVAMC)4. Alternative Treatments (Laura Baum, PhD; UVA)5. Evaluation the Bio-Psycho-Social Milieu of Pain (Ben Morasco, PhD, Steve Dobscha, MD; OHSU)6. Clinical Measurement of Pain, Opiate Addiction and Functional Status (Veronica Rodriguez, PhD; PVAMC) 7. Methadone and Buprenorphine: The place of Opiate Replacement Therapies (Andrew J. Saxon, MD; UW) 8. Procedures, Devices, Ablations, Surgeries (Andrew Engel, MD; OHSU)9. Special Issues in the Treatment of Women (Anushka Shenoy, Stacy Gramann, MD; OHSU). 10. Special Issues in the Treatment of Older Patients (Meridith Lee, DO; UVA, and Suzanne Holroyd MD; West Virginia) 11. Recovery: What does it look like? (Marv Seppala, MD, Laura Ferguson, MD; Hazelden Springbrook)
Part II. Ethical, Legal, Regulatory, and Policy Issues1. History of Opiate Prescribing and Opiate Related Drug Laws (Edward Michiana, JD, MD; Harvard) 2. Developing Facility Responses: Opiate Treatment Improvement Committee (Thomas Carr, MD; PVAMC) 3. Diversion and Abuse: pain contracts, urine drug screens, pill counts, visit frequency (Micheal H. Gendel, MD; Private Practice, Colorado) 4. Prescription monitoring programs (Johnathan Fellers, MD; OHSU) 5. Documentation of Treatment, Treatment Plan, and Informed Consent (Donna Chen, MPH, MD; UVA) 6. Emotional vs. Science Driven Treatment: The case of chronic low back pain (Rodger Chou, MD; OHSU) 7. Federal involvement in pain management policy: SAMHSA, CDC, DEA, ONDC, NIDA, US FDA (H. Westley Clark, MD, JD, MPH; CSAT)
Part III. Best Practices and Practice Models1. Multidisciplinary Pain Clinics (Travis Lovejoy, PhD; PVAMC) 2. The Role of the Emergency Room in Chronic Pain Treatment (Knox H. Todd, MD, MPH; UofT MD Anderson) 3. Assessing and Treating Co-Occurring Mental Illness (Richard Rosenthal, MD; Columbia)4. Assessing and Treating Other Co-Occurring Substance Abuse (Jyothsna Wudali, MD; Susan Whitley, MD; SUNY Downstate)
Appendix I. Resources