Intersection of chronic pain treatment and opioid analgesic misuse: causes, treatments, and policy strategies

Amy Wachholtz1, Gerardo Gonzalez1, Edward Boyer2, Zafar N Naqvi1, Christopher Rosenbaum2, Douglas Ziedonis11Department of Psychiatry, 2Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USAAbstract: Treating chronic pain in the context of opioid misuse can be very challenging. This paper explores the epidemiology and potential treatments for chronic pain and opioid misuse and identifies educational and regulation changes that may reduce diversion of opioid analgesics. We cover the epidemiology of chronic pain and aberrant opioid behaviors, psychosocial influences on pain, pharmacological treatments, psychological treatments, and social treatments, as well as educational and regulatory efforts being made to reduce the diversion of prescription opioids. There are a number of ongoing challenges in treating chronic pain and opioid misuse, and more research is needed to provide strong, integrated, and empirically validated treatments to reduce opioid misuse in the context of chronic pain.Keywords: addiction, dependence, diversion, comorbid, narcotic, treatment