Expert alert: Anesthesiologist-led consortium seeks to improve pain care in overlooked patients with chronic pain, substance use disorder and opioid tolerance

Guidelines for managing surgical pain omit patients with a history of chronic pain, substance use disorder and/or opioid tolerance. To address this disparity, the American Society of Anesthesiologists (ASA) gathered 15 medical organizations representing more than 500,000 physicians to develop seven guiding principles to improve pain management before, during and after surgery for these challenging patients.

Millions of patients fall into this category. A recent U.S. survey found over 19 million adults had at least one substance use disorder. These new principles create a “North Star” for vulnerable patients and communities dealing with multiple public health crises; offer much-needed awareness, advocacy and education for safe and effective surgical care; and represent a step forward in understanding disparities and stigma. They provide recommendations for screening, treating and educating these patients as well as when and how to consult a pain medicine specialist. For example, the organizations recommend educating patients about avoiding alcohol and recognizing the signs of overdose along with using telehealth when needed to consult with pain management experts.

David Dickerson, M.D., chair of ASA’s Committee on Pain Medicine, is available to talk about the multiorganizational recommendations, including what patients and clinicians need to know. He can address:

• Why managing pain in patients with a history of chronic pain, substance use disorder and/or opioid tolerance can be challenging.
• What the seven principles address and what clinicians and patients need to know about these new recommendations.
• The rigorous process ASA and 14 other medical organizations used to develop and come to a consensus on the seven principles.