Pain Management

[almstdn45]

How will we manage pain control in drug abusers of today when they come to the hospital with drug tolerance build up?

[CABG patch kid, BSN, RN]

Same as we do today.... Start out with the normal dose, if that's not enough, talk to the doctor to get it increased. Everyone is different in how they deal with pain and how well they tolerate it. Just because someone is a current or ex drug user doesn't necessarily mean they will automatically need massive doses of pain meds. I've worked with a lot of ex IV drug users and while their drug tolerance may have been higher than a little old lady, it was still a pretty average dose.

However, this is just my limited experience, having only been in the field for a short time. I'm sure someone with more years of experience has more to add.

[michael79]

To add on to that...my question is how long does it take someone who has abused Rx drugs in the past to return to a normal baseline tolerance for narcs. I am seeing so many cases where pts are popping Vicodin like candy for a variety of reasons, then something legit happens, they come to the hospital and we have a hard time getting their pain under control. How long does it take if they are no longer abusing the Rx?

[cmonkey]

To add on to that...my question is how long does it take someone who has abused Rx drugs in the past to return to a normal baseline tolerance for narcs. I am seeing so many cases where pts are popping Vicodin like candy for a variety of reasons, then something legit happens, they come to the hospital and we have a hard time getting their pain under control. How long does it take if they are no longer abusing the Rx?

My understanding is that people who abuse opiates, at least, often never have the same pain threshold as people how have not been abusers. It may be that they never have a "normal" baseline tolerance again. IIRC, their pain receptors are altered forevermore, and even things that the general population would consider minor can be ferociously hurtful.

I think that came from A&P...

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I'm not a doctor, but I do play one on tv.