Clinical Review
Managing Chronic, Nonmalignant Pain in Patients with a Substance Use Disorder
Fed Pract. 2005 November;22(11):10
Author and Disclosure Information
Jerome M. Sampson, MD, Shelby Havens, ARNP, Betty Marsh, LPN, and Rick Murrhee, MHS
At the time of this writing, Dr. Sampson was the primary care physician for the opioid renewal clinic and the chair of the medical center pain committee at the Malcom Randall VA Medical Center (MRVAMC), Gainesville, FL. He is now an urgent care physician (and still chair of the medical center pain committee) at the MRVAMC and a clinical associate professor in the department of psychiatry at the University of Florida, Gainesville. Ms. Havens is a mental health nurse practitioner, Ms. Marsh is the nurse team leader, and Mr. Murrhee is an addiction therapist, all for the opioid renewal clinic of the MRVAMC.
A concurrent diagnosis of substance abuse complicates the management of chronic pain with a host of clinical and legal challenges. These VA providers have found success with a highly structured, multidisciplinary clinic that combines close individual monitoring and follow-up with group patient education.