Referral--Patients

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Course 3: Referral and Co-Management of Chronic Pain Patients with Substance Use Disorders

Need

Clinicians need to be able to appropriately refer and co-manage chronic pain patients who have substance use disorders; patients may be referred for treatment of their substance use disorder, pain, or both.

Goal

The learner will be able to refer patients with substance use disorders to specialist healthcare providers and, when appropriate, participate in ongoing co-management with the specialists.

Objectives

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

A. Refer pain patients who have substance use disorders (or those who are at risk) for specialized treatment
  1. Determine when referral is possible, timely, or appropriate
  2. Determine which type of pain or addiction specialist is appropriate
  3. Refer patients to pain and addiction specialists when appropriate
  4. Refer patients to other medical and mental health specialists when appropriate
  5. Include all key patient information (history and current status) in referral report
B. Co-manage patients with specialists and other healthcare providers
  1. Obtain legal permission to share patient information with all parties involved including addiction and pain specialists, other healthcare providers, family members, and friends
  2. Distinguish between cases requiring a simple initial consultation versus ongoing co-management
  3. Establish an agreement between primary care, specialist healthcare providers, and other members of the treatment team that describes the care that each clinician will provide and includes a communication protocol and schedule of visits
  4. Continually share information as appropriate with other healthcare providers throughout the patient's treatment
C. Provide ongoing care management within the practice
  1. Query patient about status and treatment of pain at each visit
  2. Query patient about status of addiction treatment or recovery and treatment by other members of the treatment team at each visit
  3. Continually re-assess risk and screen for substance abuse and refer back to the addiction specialist as needed

Case Study/Simulated Patients - IN DEVELOPMENT

Core Courses: Initial AssessmentInitial PrescribingOngoing ManagementAvoiding Diversion

Clinical Application Courses: Focus on Pain ConditionsFocus on Substance Use Problem

Standardized Patients: Pain and Addiction Standardized Patient Example 1


Pain and Addiction References