| Abstrakt: |
Chronic pain and addiction are highly prevalent, and both exact a terrible cost to the patients and families who suffer from them. Providers must approach these problems in a rational, deliberate, and evidence-based manner, but insufficient training and pervasive stigma present significant barriers. The resulting miscommunication, often fueled by misaligned expectations, mistrust, and fear of abandonment, can further erode the therapeutic alliance and lead to both under and overprescribing. Patients with evolving substance use disorders or comorbid pain and addiction present a particular challenge, and providers may struggle to approach such patients objectively. Controlled substance agreements, pill counts, and urine drug tests may improve safety and guide care, but only if used transparently and in a noncoercive manner. In this manuscript, these and other communication challenges are explored along the continuum of pain management and addiction care, and contextspecific suggestions are offered to empower the clinician to overcome them. [ABSTRACT FROM AUTHOR] |
