Managing Pain in the Setting of Opioid Use Disorder.
Barbara St Marie, Kathleen Broglio
PMID 31648905WHAT IT FOUND
Managing pain in patients with opioid use disorder means screening withdrawal and suicide risk, using multimodal analgesia, and coordinating medications for opioid use disorder.
High-quality evidence is limited, but nurses can assess, educate, and plan safe discharge.
Key findings
01The article gives evidence-informed guidance rather than new trial results, and it states that high-quality treatment evidence is limited.
02Screening for opioid withdrawal and suicide risk is within pain management nurses' scope, and nurses are well positioned to initiate this assessment.
03Multimodal analgesia is recommended, but for acute pain in people taking buprenorphine, no consensus best-practice protocol has been established.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review and expert guidance, not a trial or systematic review that tested a treatment; it reports no new patient outcomes. The authors state that high-quality treatment evidence is limited, so many recommendations rely on cited studies and expert opinion. It does not show that any medication or nonpharmacological approach improves pain or opioid use disorder outcomes. It gives no participant data, no measured treatment effects, and no direct comparison of continuing versus stopping buprenorphine, methadone, or naltrexone. Prevalence estimates for opioid use disorder among people prescribed opioids are uncertain because definitions and studies differ. For acute pain in people taking buprenorphine, multiple protocols are described, but consensus best practice has not been established.
Declared interests
The supplied metadata indicates NIH extramural research support; no author conflict-of-interest declaration is included in the provided text.
The easy way to misread this
Do not read the medication and pain-management recommendations as proven by this paper alone. It is a narrative review and expert guidance; it says high-quality evidence is limited and best-practice protocols for acute pain in people taking buprenorphine are not established.