Addiction Recovery

From Clinicaltools.com

Contents 1 Course Alternative 7: Recovery 1.1 Need 1.2 Goal 1.3 Objectives 1.3.1 Objective A. Treat Patient in Recovery 1.3.2 Objective B. Prevent Abuse and Relapse 1.3.3 Objective C. Detect Abuse and Relapse 1.4 Case Study/Simulated Patients 1.4.1 Regina Recovered: 62 YOWF

Course Alternative 7: Recovery

Managing Pain Patients Who Are In Addiction Recovery

Need

Clinicians need to know how to manage acute and chronic pain patients who are currently in recovery from addiction.

Goal

The learner will manage pain and addiction treatment in order to provide appropriate dosing for pain and to prevent relapse among patients who are in recovery from addiction.

Objectives

After completing this course, the learner will be able to:

Objective A. Treat Patient in Recovery

Determine optimal dosing and duration of pain treatment for patients in recovery from opioid addiction

1. Determine the adequate but lowest dose of pain medication that is likely to be effective to treat the pain
2. Choose medications that provide stable blood levels (long acting, slower onset) if appropriate
3. Determine the appropriateness of non-opioid pain medications alone or in combination with opioids
4. Determine the appropriateness of non-pharmacological treatments, such as cognitive-behavioral therapy, physical therapy, and complementary and alternative medicine (CAM) treatments

Objective B. Prevent Abuse and Relapse

Employ pain treatment strategies to prevent relapse in patients in recovery from addiction

1. Prescribe less-addicting pain medications
2. Determine the appropriateness of non-opioid pain medications
3. Determine the appropriateness of non-pharmacological treatments, such as cognitive-behavioral therapy, physical therapy, and complementary and alternative medicine (CAM) treatments
4. Recommend intensification of relapse prevention activities
5. Increase frequency of visits and decrease size of prescription

Objective C. Detect Abuse and Relapse

Employ strategies for recognizing abuse and relapse in patients who are in recovery

1. Use sensitive interviewing techniques to inquire about patient's cravings or thoughts about using substances again
2. Identify behavioral red flags suggestive of substance abuse and/or relapse to addiction
3. Monitor pain medication use through pill counts

Case Study/Simulated Patients

Regina Recovered: 62 YOWF

• Chief Complaint: Severe pain from self-diagnosed frozen shoulder.
• Narrative: Regina was formerly addicted to prescription opioids after a previous episode of frozen shoulder on the other side 10 years ago. She has been in recovery for 5 months. She started treating pain herself by taking "some old pills I had lying around." She ran out and asks for a prescription for oxycodone.
• Social history: Recently widowed.
• Challenges: Lack of social support
• Objective Addressed: 3. Employ strategies for preventing and recognizing abuse and relapse
• Clinical Skills:

1. Identify behavioral red flags suggestive of abuse and/or relapse to addiction
2. Monitor pain medication use through pill counts
3. Increase frequency of visits and decrease size of prescription