Advisory: Opioid Therapy in Patients With Chronic Noncancer Pain Who Are in Recovery From Substance Use Disorders

This guide equips clinicians with information for treating chronic pain in adults living with a history of substance use. The guide discusses chronic pain management, including treatment with opioids. It also includes information about substance use assessments and referrals. Access the literature review.

This updated TIP is designed to help providers and others better understand how to identify, manage, and prevent substance misuse in older adults. The TIP describes the unique ways in which the signs and symptoms of substance use disorder (SUD) manifest in older adults; drug and alcohol use disorder screening tools, assessments, and treatments specifically tailored for older clients' needs; the interaction between SUDs and cognitive impairment; and strategies to help providers improve their older clients' social functioning and overall wellness.

This Advisory, based on TIP 49, Incorporating Alcohol Pharmacotherapies Into Medical Practice, focuses on medication and related treatment decisions made after screening and assessment for AUD, and medically supervised withdrawal, if necessary. Alcohol consumption should not stop abruptly in those patients who have consumed alcohol regularly over a prolonged period of time. This Advisory is meant as an overview of AUD medications to facilitate abstinence.

The Rx Pain Medications. Know the Options. Get the Facts. is a series of 13 fact sheets designed to increase awareness of the risks associated with prescription opioid use and misuse, as well as to educate patients who are prescribed opioids for pain about the risks and to provide resources on methods for alternative pain management. This particular fact sheet focuses on alternative pain management methods such as acupuncture, cognitive behavioral therapy, and meditation.

This updated (March 2020) TIP is intended to provide addiction counselors and other providers, supervisors, and administrators with the latest science in the screening, assessment, diagnosis, and management of co-occurring disorders (CODs).