Managing Acute and Chronic Pain in a Substance Abuse Treatment Program for the Addicted Individual Early in Recovery: A Current Controversy‪.‬

Substance abuse is a common and serious problem in the United States. Current estimates reveal that 6% to 14% of the population abuse alcohol and 3% to 4% of the population abuse other drugs (Galanter & Kleber 2004). The impact of alcohol and other drug abuse on American society is enormous given the resources going into treatment, hospitalization, incarceration, and lost productivity. Besides the economic toll on society, alcohol and drug addiction can devastate families and destroy friendships. Substance abuse treatment facilities face a myriad of challenges in their normal daily operations. One problem is how to handle the addicted patient with either acute or chronic pain. Given the chronic and recurring nature of the disease, physicians are justifiably concerned about placing these patients on potentially addicting medications. Frequently these patients do not want to stop their opioid pain medications and many practitioners view this attitude as proof of the patient's lack of commitment to treatment or, worse yet, evidence of drug-seeking behavior.