Pain Management After TBI and Substance Abuse

From prescribing only small amounts of medications to preventing "doctor shopping," the medical team — and the person with TBI and addiction issues — must collaborate to make pain management effective.

This is an excerpt from BrainLine's webcast Substance Abuse and TBI. See full webcast here.

Let's talk about the obvious challenge when you've got pain management after a brain injury. How do you prescribe medication if problems with drugs and alcohol are already involved? Well, pain management is absolutely critical-- particularly when dealing with a substance abuse problem. [Naval Center for Combat & Operational Stress Control] Again, you go back to the collaborative process of treating these things. And the collaboration, in that case, also includes the patient. You have to be very upfront and very honest with the patient about addressing that. The first thing, though, is to make sure that you are identifying what is causing the pain and make sure you get that treated and taken care of. And then, in managing the pain medication situation or the pain treatment, close follow up, frequent follow up; small prescriptions so that they don't have large supplies, making sure that the providers are coordinating with each other so that they aren't doctor shopping to get a little bit from here, a little bit from there, and collecting a bunch--that's part of that collaborative approach that we have to take. Female Interviewer: I see Jan is over there saying, "Yep, that's right." Jan: Yes, absolutely. I would've been the doctor shopper, [brainline.org] and so yes, it is really, really important to be able to have that level of accountability.
Posted on BrainLine November 29, 2011.

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