Schmerztherapie bei suchtmittelabhängigen Patienten

Abstract

Each individual is entitled to an adequate and sufficient pain therapy. However, only a few studies have examined the peculiarities of pain management in drug-dependent or formerly addicted patients. Any addiction is disadvantageous for a successful pain therapy, since some of the prescribed drugs may themselves cause addiction. Drug-dependent patients are often tolerant to opioids. Additionally, there is a risk of iatrogenic pain becoming chronic due to disregard for already known risk factors and comorbidities. However, a history of addiction should not prevent sufficient pain therapy, especially since there is no risk of addiction when the pain therapy employed is adequate for the pathophysiology involved. There are adequate pain therapies for addicted patients. The best results are achieved by taking into account the physiological and psychological peculiarities of drug-dependent patients. Importantly, this should be combined with a variety of different, optimized, multimodal therapeutic regimes, as well as with an interdisciplinary approach.

Pharmacotherapy in Pain Patients with Substance Abuse

“…1,7 Although opioids may provide pain relief for many types of chronic non-cancer pain, 2 alone they are rarely sufficient. Treatment of chronic non-cancer pain should start with non-opioid analgesics accompanied by non-pharmacological therapies and treatment of psychological comorbidities.…”

“…1,2 Physical dependence describes adaptive changes in the body in response to a repeated drug intake, which may cause tolerance. 2 Abrupt omission of the drug provokes symptoms of withdrawal.…”

Defizitäre Schmerztherapie bei Suchtpatienten

“…Von den im Krankenhaus aufgenommenen Patienten weisen z. B. in chirurgischen Fä-chern 20-50 der Fälle suchtmittelbezogene Störungen auf [1,6]. Diese Patienten haben eine erhöhte Komorbidität.…”