Patients managing chronic and complex conditions are often also trying to control chronic pain. Proper pain monitoring and routine medication review can prevent abuse of drugs, particularly opioids, alcohol or other substances. Care coordination entails instruction for appropriate use of pain medications, timely scheduling of appointments, ensuring prescription refills, and important preventive health reminders. It also includes providing chronic care patients with the right pharmacological and psychological treatment options and information for effective self-care.
The use of opioids as a treatment for chronic pain remains a topic of considerable debate. Until recently, opioids were reserved primarily for the treatment of acute pain or even cancer-related pain. However, recent studies have shown that long-term opioid use and prescription is increasingly common in patients managing chronic pain. Patients prescribed opioids are also being prescribed antidepressants and other psychotropics. Many of these same patients are either using or at risk for drug and alcohol dependence and addiction. The prevalence of dependence and addiction in patients dealing with chronic pain is significant. Persons with a previous history of substance abuse are at increased risk for relapse during chronic pain treatments.