Acute Pain and Substance Abuse in Surgical Patients

Objectives After reading this article you should be able to: Discuss actions and side effects of commonly used pain medications. Identify beliefs about pain control. Differentiate the need for postoperative pain medication of persons who do not abuse substances and those who do. Identify behaviors which may indicate drug abuse. Determine actions for effective pain management in persons who abuse substances. Studies have determined that nurses and physicians undermedicate patients for postoperative pain as a result of inadequate knowledge and erroneous attitudes. Fear of addiction seems to be the major reason for this undertreatment. A patient who abuses drugs requires larger than usual doses of narcotics postoperatively; however, larger doses are rarely given. This article emphasizes factors influencing the postoperative pain experience and presents 3 case studies to illustrate pain management in patients who abuse substances.