Challenges of Managing Chronic Pain with Opioids – Part 2

Published

In this episode of Curbside Consults, we continue our exploration of the prescription and use of opioids in the treatment of chronic pain. We hear a patient’s point of view, exploring how a patient with chronic pain manages his relationship with his provider, pharmacy, and society. In a previous episode of this two-part series, we examined case scenarios about worrisome opioid use and discussed how clinicians can manage their feelings during these difficult patient visits. This discussion is based on the NEJM Knowledge+ module on Pain Management and Opioids, available free at knowledgeplus.nejm.org.

0:00 – Introduction preamble
0:59 – Introduction of panelists
1:49 – Chronic pain: the patient experience
3:24 – Prescribing opioids safely to patients who need them
5:14 – Obstacles in the patient–physician relationship and chronic pain
8:11 – Optimizing opioid dosing with chronic pain
9:41 – Pseudo-opioid resistance and physician trust
12:59 – The fear of losing your primary provider
14:20 – Can knowing too much hurt you?
17:49 – Final thoughts: patient perspective
19:28 – Final thoughts: physician perspective
20:03 – Outro

The information in this podcast is based on the NEJM Knowledge+ module on Pain Management and Opioids.

- For more information about the free NEJM Knowledge+ Pain Management and Opioids module, click here.
- For more information about Scope of Pain, click here.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

Dr. Daniel Alford is Professor of Medicine, Associate Dean of Continuing Medical Education and Director of the Safer and Competent Opioid Prescribing Education or SCOPE of Pain program at Boston University School of Medicine. He is on staff in the Section of General Internal Medicine and director of the Clinical Addiction Research and Education Unit at Boston Medical Center. His clinical, educational and research interests focus on managing opioid use disorders and safer opioid prescribing for pain.

 Ahmad is a 2019-2020 editorial fellow at the New England Journal of Medicine. He is from Toronto, Canada where he is completing his training in pulmonary medicine at the University of Toronto.