NIDA Series to Explore Ways Psychiatrists Can Help Patients in Pain
Abstract
Best practices for recognizing and treating patients with chronic pain and opioid use disorder and federal plans to address the nation’s opioid epidemic will be among the topics covered at APA’s Annual Meeting in a special track.
Since 1999, the number of Americans who have died from opioid overdose has quadrupled, as has the number of prescription opioids sold in this country. What can psychiatrists do to support patients struggling with chronic pain and/or opioid use disorder?
Nora Volkow, M.D., director of the National Institute on Drug Abuse, points out that psychiatrists have many tools that can help fight opioid use disorder and chronic pain.
“[T]he reality is that the epidemic was in part born by the inappropriate treatment of pain and overreliance on prescription opioids,” National Institute on Drug Abuse (NIDA) Director Nora Volkow, M.D., told Psychiatric News. NIDA will sponsor multiple sessions at APA’s Annual Meeting in San Diego on how psychiatrists can help patients with chronic pain and/or opioid use disorder.
“Psychiatrists can play an extremely important role in highlighting other therapies, besides opioids, to treat pain,” she said.
The NIDA symposium will begin Sunday, May 21, with a session on how psychiatrists with no background in pain management can recognize pain in patients. Tips on how best to treat these patients—including pharmacological and nonpharmacological approaches to pain and how to avoid common pitfalls in pain management—and when to refer to specialty care will be discussed.
Recognizing and treating patients with a history of pain and opioid use disorder can be particularly challenging. As part of the NIDA series, Sean Mackey, M.D., Ph.D., chief of the Division of Pain Medicine at Stanford University School of Medicine, will present a series of cases of patients with opioid use disorder and chronic pain in a session on Monday, May 22.
Among other topics, the session will address the importance of nonopioid adjuvants for pain management, such as acetaminophen and nonsteroidal anti-inflammatory drugs; nonpharmacological pain management therapies; and appropriate monitoring and risk mitigation strategies.
Also on Monday, Volkow will give an overview of the current opioid epidemic and the multipronged strategy by federal health agencies to reduce rates for prescription opioid misuse and overdose. These strategies include improving the education of health care professionals on pain management, providing treatment to individuals misusing prescription opioids, and increasing the availability of the opioid antagonist naloxone, which blocks the effects of opioids and reverses an overdose.
Volkow will also discuss the efforts of federal health agencies to explore the effectiveness of nonopioid treatments for pain, including cognitive-behavioral therapy, antidepressants, and neurostimualtion therapies.
The symposium will conclude on Wednesday, May 24, with the session “What Is Pain to The Brain?,” co-chaired by NIDA Deputy Director Wilson Compton, M.D. The session will include a discussion of the involvement of endogenous opioid, endocannabinoid, and dopamine systems in the regulation of pain as well as how emotions contribute to pain amplification and suffering.
“If you are in pain, you have a greater risk of developing depression. If you are depressed and have pain, you are at a greater risk for transitioning to chronic pain,” Volkow said. “Psychiatrists can play an important role in treating patients suffering from chronic pain.” ■
Register for the 2017 Annual Meeting to attend the NIDA series, and 450+ of other educational sessions. Dates, times, and locations of the NIDA sessions will be published in the Annual Meeting program distributed at the meeting and in the APA Meetings App.
