American Society for Pain Management Nursing Position Statement: Pain Management in Patients with Substance Use Disorders

Abstract

The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high quality pain assessment and management. Failure to identify and treat the concurrent conditions of pain and substance use disorders will compromise the ability to treat either condition effectively. Barriers to caring for these patients include stigmatization, misconceptions, and limited access to providers skilled in these two categories of disorders. Topics addressed in this position statement include the scope of substance use and related disorders, conceptual models of addiction, ethical considerations, addiction risk stratification, and clinical recommendations.

Nurses' competence in pain management in patients with opioid addiction: A cross-sectional survey study

“…Besides having a higher incidence of pain, the pain is also generally untreated or undertreated (Kirsh and Passik, 2006;Oliver et al, 2012). Unrelieved pain causes unnecessary suffering and inability for self-care, and reduces quality of life (Grant et al, 2007).…”

“…Unrelieved pain causes unnecessary suffering and inability for self-care, and reduces quality of life (Grant et al, 2007). Evidence show that stress from poorly treated pain may exacerbate an existing addiction (Oliver et al, 2012). The complex challenge in management of pain is made more so when dealing with opioid abusers, because they are met with negative attitudes or stigmatized by health care professionals (Oliver et al, 2012).…”

“…Evidence show that stress from poorly treated pain may exacerbate an existing addiction (Oliver et al, 2012). The complex challenge in management of pain is made more so when dealing with opioid abusers, because they are met with negative attitudes or stigmatized by health care professionals (Oliver et al, 2012). This population represents a challenge to nurses' professional competence to provide effective pain treatment.…”

“…Opioid abusers often develop serious bacterial infection, injuries and trauma (Ford et al, 2008), painful conditions that may require hospitalization. Although addiction is a significant public health problem, so too is the undertreatment of pain (Oliver et al, 2012).…”

Treating Pain in Addicted Patients: Recommendations from an Expert Panel

“…Common misconceptions about pain and substance use disorders, such as tolerance for and dependence on prescribed opioids as signs of addiction, can further complicate optimal care. 5 Another barrier is access, as more than 50% of patients do not seek mental health care because of cost. 6 As the misuse and abuse of opioids continues to burgeon, clinicians must be particularly vigilant when prescribing chronic opioid therapy (COT).…”