Acute Pain

Individuals with an addiction often experience high levels of anxiety in association with the stress of trauma, illness, or surgery, which may affect how they experience and express pain. In these patients, healthcare professionals should provide reassurance that the patient’s addictive disease will not impede pain relief. Including the patient in decision-making regarding medication choices, dosing and scheduling provides the patient with a sense of control and allays anxiety over whether the pain will be adequately treated, and may make treatment easier for both patient and the healthcare team. Patients with active opioid abuse may require relatively high doses during the treatment of acute pain.^1,3  In the controlled setting of the hospital, it is usually better to assume that the patient is describing truly experienced pain and to dose as aggressively as is needed to bring relief, as long as this does not compromise safety by producing an unacceptable degree of sedation.

When pain is anticipated (e.g., postoperative elective surgery), a pain treatment plan should be developed in advance. Without adequate pain control, patients may crave pain-relieving medications and experience anxiety, frustration, anger, and other feelings that may complicate management.