Treating Comorbid Opioid Use Disorder in Chronic Pain
This in-depth text addresses how to approach and treat the chronic pain patient struggling with problematic opiate use. It discusses the approach for patients who may be at high risk of problematic use, such as those with a history of mental illnes
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Annette M. Matthews Jonathan C. Fellers Editors
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Treating Comorbid Opioid Use Disorder in Chronic Pain
Annette M. Matthews • Jonathan C. Fellers Editors
Treating Comorbid Opioid Use Disorder in Chronic Pain
Editors Annette M. Matthews, M.D. Department of Psychiatry Oregon Health and Science University Portland, OR, USA
Jonathan C. Fellers, M.D. Department of Psychiatry Maine Medical Center Portland, ME, USA
Department of Medical Informatics and Clinical Epidemiology Oregon Health and Science University Portland, OR, USA Portland VA Medical Center Portland, OR, USA
ISBN 978-3-319-29861-0 ISBN 978-3-319-29863-4 DOI 10.1007/978-3-319-29863-4
(eBook)
Library of Congress Control Number: 2016938003 © Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland
Preface
Chronic noncancer pain affects more than 100 million Americans and can be caused by many conditions including osteoarthritis, low back pain, musculoskeletal pain, injury-related pathology, and diabetic neuropathy. It is estimated that the 1-month prevalence of moderate to severe noncancer pain is 19 %. Opioids can be an effective way to treat this pain, but not without risk. The goal of the book, Treating Comorbid Opioid Use Disorder in Chronic Pain, is to address how to approach and treat the chronic pain patient struggling with problematic opioid use. Chronic pain serves as a conduit for problematic opioid use and addiction. Brain regions including the nucleus accumbens, the amygdala, and the hypothalamus are involved in both the mechanisms of pain and opioid dependence. The problematic use of opioids in this population can present as a range of issues including recreational use, physical dependence, pseudoaddiction, opioid-induced hyperalgesia, engagement in illicit activity, cross-addiction to street heroin
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