Behavioral Medicine: A Guide for Clinical Practice, 5e >Opioids

Mitchell D. Feldman, John F. Christensen, Jason M. Satterfield, Ryan Laponis+

Table 25-5.Distinguishing uncontrolled pain from opioid withdrawal.

Useful questions
•What happens when you miss or are late for a dose of your pain medicine?
•Walk me through a typical day, including how and when you take your pain medication.

Patterns that suggest uncontrolled pain

•Increased pain is reliably associated with increased physical activities.
•Patient increases opioid use prior to planned activities.
•Patient decreases opioid use when not working or not physically active.
•Stable monthly opioid dose over time.

Patterns that suggest withdrawal

•Rhinorrhea, restlessness, or other nonpain symptoms just before the next opioid dose.
•Patient needs opioids to get out of bed in the morning.
•Patient takes opioids to avoid getting sick or to “stay normal.”
•Patient takes opioids to help with sleep or anxiety.
•Pain when missing opioids is different than pain for which opioids are prescribed.

Date of download: 12/27/22 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.