Table of Contents
Substance Abuse Issues in Chronic Pain Management
The Four “A’s” of Pain Treatment Outcomes
The 4 A’s: Analgesia
The 4 A’s: Analgesia
The 4 A’s: Activities of Daily Living
The 4 A’s: Adverse Side Effects
The 4 A’s: Adverse Side Effects
Aberrant Drug-taking Behaviors: The Model
Creating a Checklist for Monitoring Outcome During Long-term Opioid Therapy
4th “A” - Aberrant Drug-related Behavior Adverse consequences possibly resulting from drug use
4th “A” - Aberrant Drug-related Behavior Possible loss of control or diversion of medications
4th “A” - Aberrant Drug-related Behavior Preoccupation with opioids or other drugs
4th “A” - Aberrant Drug-related Behavior Other occurrences of potential concern
Differential Diagnosis of Aberrant Drug-Taking Attitudes and Behavior
Defining the Problems
What is the Risk of Addiction and Aberrant Behavior?
Spectrum of Risk of Addiction or Aberrant Behavior
PPT Slide
“Pseudo-Addiction”
Consider the Risk of Not Treating Pain in Addicts
The Non-Addicted Pain Patient Who Is a “Chemical Coper”
Tailoring The Approach
Summary
Redefining Addiction for the Chronic Pain Setting
What Addiction Isn’t: Physical Dependence
What Addiction Isn’t: Tolerance
DSM-IV Substance Use Disorder and the Typical Pain Patient on Opioids
Behaviors That Raise the Suspicion of Addiction
Summary
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