Pain management and addiction medicine are two specialized fields of
medical practice that share a strong common interest in the mechanisms,
clinical use, risks and benefits associated with opioid drugs and other
therapies involving potentially abusable medications. In addition, there
are profound clinical interactions between the potential for addictive
disorders and the occurrence of unrelieved pain, which influence both
the management of substance use disorders and the care of pain patients.
Despite this commonality of interests and concerns, the disciplines of
pain management and addiction medicine have developed largely in isolation
from one another. Equally important, both disciplines have been relatively
marginalized in the education and training of clinicians. The separation
of research and clinical practice applied to pain and addiction, and the
failure to present all clinicians with a cohesive training approach in
these disciplines, would seem to have negative consequences for both individuals
and society in general. It may contribute to the undertreatment of pain,
the medical abandonment of those dependent on opioids and wanting and
needing help, the stigmatization of opioid drugs, and the placement of
excessive regulatory barriers on clinical practice.
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