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Pain Management Blog



09Mar

Managing Opioid Disorder in Patients

Providing pain solutions for patients is what our clinic at Republic Pain Specialists works for. What’s more, with each pain management program we help create, we are reducing the number of opioid prescriptions that get issued each year. There are times we interact with patients who are already dealing with opioid disorder and we need to take extra steps to manage their care. We also know that there are members of our community and medical professionals in other fields, who want to be able to identify the issue and get their patient or loved one back on track.

Background

Despite the amount of information available, to the general public and medical professionals, opioids are still having a negative impact on our society. According to the American College of Emergency Physicians, there was a fourfold increase in death related to opioids in the years of 2002-2017. Additionally, many patients are being admitted to the hospital each year to deal with overdose and other emergencies related to opioid use. The same article states that time in the hospital “provides the perfect opportunity to start patients on treatment and kick-start their path to recovery.”

Recognizing Withdrawal

The first step of the medical professional, family member, or friend in these interactions is to observe the signs of opioid withdrawal. Many patients may present with seemingly gastroenteritis, possibly having severe abdominal cramps, nausea, vomiting, muscle aches, and chills. Other patients may exhibit signs of anxiety, hypertension, restlessness, watery eyes and nose, and other symptoms. The half-life of the opioid depends on what the patient has been taking, but withdrawal symptoms may be seen in patients who have been taking opioids for as little as five days.  

Steps for Management

Once a patient has been identified as having opioid withdrawal, there are five steps medical professionals can take to try assisting those under their care. If you are not a medical professional, there are a number of outlets where you can reach out for help.

1. Identify if the patient meets the criteria for opioid use disorder. There are a number of questions medical professionals can use to determine these criteria. Among your conversation with your patient, you may discover recurrent use leads to unfulfilled work, school, and personal obligations, that the patient exhibits a tolerance to opioids, and a large amount of time is spent to managing and obtaining opioids in the patient’s life.

2. Assess the patient’s readiness to quit. By speaking to the patient about their goals and willingness to work through the process of stopping opioid use, you can determine if further action should take place. Consent and input are necessary for patients to continue.

3. Assess severity of opioid withdrawal. Medical professionals should use the Clinical Opiate Withdrawal Scale as an assessment tool for determining how severe the patient’s withdrawal is. This tool assigns points for symptom’s shown and will help the medical team pinpoint where a patient is.

4. Withdrawal symptom treatment. There are a number of ways to provide this. The American College of Emergency Physicians suggests use of buprenorphine-naloxone if a patient can tolerate it, dependent on their cardiac function and addiction to other substances. This will help manage pain and withdrawal symptoms in a less destructive way than opioids. Other treatments may be offered including counseling and education about alternative pain relief methods.

5. Counsel and arrange follow-up. Crucial to the recovery process is ongoing support for the patient. While medical professionals may not always be the best option for the support each patient needs, there should be a system in place for referral to the care they need. By having resources ready for these patients ahead of time, you can be ready for this step. Follow-up should take place within two days.

The counsel and follow-up portion of treatment will be important for the family and friends who are involved. Not only will they be leaned on in tremendous ways, but they may need to reach out for support of their own.

Republic Pain Specialists are passionate about giving every patient the opportunity for the relief they need from pain. Whether they are dealing with chronic pain or need relief from surgery or injury, there are solutions. To learn more about how you can work with our team, being fully involved in your pain relief and management, contact us today.

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