Substance dependence and tolerance in managing pain


Chair: Felicia Cox
Ethical issues in manging substance-related pain
Georgina Morley, United States
In this presentation, I will describe the ethical considerations of managing pain for patients with substance dependence. I will describe why pain management is an ethical issue and provide a short case that will be the backdrop for an overview of the Four Principles of Biomedical Ethics plus Scope. I will highlight how each principle may be considered in the case, highlight how pain management can cause healthcare professionals to experience moral distress and conclude by offering four questions that are helpful for nurses to consider the ethical aspects of providing pain management.
Acute pain management in opioid tolerant patients
Susan Broekmans, Belgium
Substance dependence and managing pain
Felicia Cox, United Kingdom
Opioids, alcohol and caffeine are not the only substances that are subject to misuse. Others that are commonly misused include stimulants (amphetamines, khat and cocaine), depressants (alcohol, barbiturates, benzodiazepines) and hallucinogens (cannabis, synthetic cannabinoids, mescaline and lysergic acid diethylamide).
This session will provide an overview of how to care for patients with acute or persistent pain who have a substance use disorder, as well as how to recognise and treat withdrawal. Promoting open and honest non-judgemental conversations can promote more transparent history taking and develop a trusting relationship which is key to planning care.
Communication is the foundation of care thus the pain nurse specialist should be developing plans of care with the patient and liaising with primary care (General medical practitioner), substance misuse teams (drug & alcohol/addiction services), carers and supporters to ensure that treatments are monitored and that rehabilitation services are accessed.


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