What are the pain management options for patients with a history of opioid abuse?

Updated: Jun 21, 2018
  • Author: David W Dixon, DO; Chief Editor: Glen L Xiong, MD  more...
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Answer

Several options are possible, and the most effective approach will be determined with increasing clinical experience:

  • Continue BMT and titrate a short-acting opioid analgesic to effect.

  • Divide buprenorphine dose to 6-8 hours to take advantage of its short-acting analgesic properties.

  • Discontinue BMT, implement opioid analgesia, and restart BMT when opioid analgesia is no longer necessary.

  • In the hospitalized patient, discontinue BMT, initiate MMT, and add short-acting opioids to treat pain. Have naloxone at bedside. Convert back to BMT prior to discharge from hospital.


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