Clinical Case Discussion on the Assessment and Management of Opioid Use Disorders in the General Hospital Setting



Joji Suzuki, MD 
Director, Division of Addiction Psychiatry, Brigham and Women's Hospital 

John A. Renner, MD, DLFAPA
Professor of Psychiatry, Boston University School of Medicine
 
June 18, 2014
 
This session builds on Dr. Suzuki’s June 10 session and features a clinical case discussion on the assessment and management of opioid disorders in the general hospital setting    
 
Hospitalized patients often experience significant pain associated with their illnesses or injuries, and even those actively addicted to opioids may still require pain relief. However, research has almost exclusively focused on outpatients with chronic pain rather than medical inpatients with acute pain.
 
In the absence of objective biomarkers for pain, differentiating those patients in acute pain from those who are seeking opioids for non-medical reasons remains challenging in the acute medical setting. Patients misusing opioids are prone to painful conditions from trauma, soft-tissue infections, and overall poor health. They may require higher opioid doses due to tolerance and hyperalgesia, and may be undertreated due to bias about addiction.
 
Given that adequate pain relief has become an important goal in hospital settings, this presentation will provide some guidance on how to assess and manage medical inpatients who may be requesting prescription opioids for non-medical reasons.
  
Slide set