How do you carefully manage pain in patients who have a history of substance abuse? Balancing effective relief while minimizing the risk of relapse or addiction seems really challenging.
History of patient is very important, since the patient is a substance abuser we have to keep non-opioids therapies as the key.
Along with that , rehabilitation care, regular monitoring along with addressing any other co-existing conditions in the patient.
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Managing pain in patients with a history of substance abuse involves a careful balance of providing adequate analgesia while minimizing the risk of relapse. This typically includes using multimodal pain management strategies—such as NSAIDs, acetaminophen, and adjuvant therapies—before considering opioids. If opioids are necessary, they should be prescribed at the lowest effective dose with close monitoring and clear treatment goals. Collaboration with addiction specialists and regular assessment of pain, function, and potential misuse are essential to ensure safe and effective care.