Management of Co-Occurring SUD and Chronic Pain

Abstract

Though there has been a 44.4% decrease in the number of prescriptions written for opioid analgesics between the years 2011–2020 in the United States, drug overdose rates continue to climb sharply, reaching nearly 107,000 for a prior 12-months period as of early 2022, driven primarily by the use of illicit opioids. It is estimated that 80–90% of individuals with a substance use disorder (SUD) receive no treatment, and for those with opioid use disorder (OUD) who do find their way to treatment, less than half are offered potentially life-saving medication. Contemporaneously, chronic pain is one of the most common and most disabling health conditions, and frequently involves complex decision-making between the patient and the health care team regarding the treatment approach. Though prescribing trends have ebbed in recent years, opioids continue to be the most prescribed class of drug in the United States despite well-publicized associated harms. It is more critical than ever that stakeholders urgently work to facilitate and destigmatize evidence-based substance use disorder treatment, and promote safe, effective, and holistic care pathways for patients suffering from chronic pain.