Page 24 - Delaware Medical Journal - May 2017
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Integration of Behavioral Health in Comprehensive Pain Management Care — Two Case Reports
Pranesh Patel, MS4; Imana Milton, MBA, MS; Ganesh Balu, MD; Dave Parcher MS, LPCMH, LCPC, CAADC
BACKGROUND
Opioid Use Disorder (OUD) is a form of Substance Use Disorder (SUD). While of a substance despite ongoing negative consequences in the DSM-V, OUD is characterized by the compulsive use of opioids despite adverse consequences relationships, and the development of
a withdrawal syndrome when use is interrupted. Opioids include drugs such as morphine, heroin, codeine, oxycodone, and hydrocodone. The presenting characteristics of the medical diagnosis
are a preoccupation with a desire to obtain and take the drug persistently, as well as exhibiting drug-seeking behavior.
Undiagnosed, poorly treated or
untreated OUD/SUD is associated both pain management and psychiatric overutilization of healthcare resources.1
It is common for pain practices to discharge their patients, abruptly discontinue pain medications, or refer the patients to outside addiction medicine and counseling professionals when patients have positive drug screens for
illicit drugs. In such instances, patients are more likely to resort to illicit use, seek medications from other diverted routes, or over utilize urgent care and emergency rooms. Such actions often add to the already existing negative consequences. Furthermore, these patients may not get the adequate care for their chronic pain condition in such parallel systems of care.2 If chronic pain is not adequately managed, these patients relapse back to their OUD/SUD quickly and it becomes a revolving door for this population — going in and out of detox centers and/or urgent care centers that are not equipped to treat chronic pain.
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Del Med J | May 2017 | Vol. 89 | No. 5
