Managing acute pain in people with substance-use disorder

Acute pain in patients with substance-use disorder other than opioids can be managed according to the general principles of acute pain management. These patients are generally not opioid tolerant.

When managing acute pain in patients with substance-use disorder, the following considerations are required:

• acute pain management can be complicated and patients may require longer hospital stays
• withdrawal from psychoactive substances may require additional monitoring; in particular, amfetamine withdrawal can cause sedation, making opioid analgesic titration difficult
• there is an increased risk of diversion and misuse of opioids; avoid prescribing opioids upon discharge, if possible.