Co-Occurring Pain Disorders in Addiction Medicine (2025-2026 Recording)-Co-Occurring Pain Disorders in Addiction Medicine Recording

Video Transcription

Video Summary

This lecture from the American College of Academic Addiction Medicine focused on co-occurring pain disorders in addiction medicine, emphasizing that chronic pain and substance use frequently intersect and must be treated together. The speakers reviewed chronic pain definitions, the high prevalence of pain among people with substance use disorders, and the “reciprocal model,” in which pain can drive substance use and substance use can worsen pain.<br /><br />A major theme was multimodal, individualized care. The presenters discussed practical assessment tools like the PEG scale and reviewed pain types: nociceptive, neuropathic, and nociplastic pain. They walked through cases highlighting inpatient and outpatient management, including continuing MOUD, splitting methadone or buprenorphine doses for analgesia, and safely using full agonist opioids when needed.<br /><br />The pharmacology section covered topical agents, NSAIDs, muscle relaxants, opioids, fentanyl patches, transdermal and buccal buprenorphine, methadone, TCAs, gabapentinoids, and SNRIs like duloxetine. They stressed the importance of matching medication choice to pain type, avoiding overreliance on opioids, and understanding formulation-specific nuances and risks.<br /><br />The second half focused on pain psychology and integrative care. Evidence-based behavioral approaches included CBT, ACT, pain reprocessing therapy, and mindfulness-oriented recovery enhancement. The lecture also reviewed interventional pain procedures, physical therapy, acupuncture, chiropractic care, and emerging therapies such as TMS and neurosteroids.<br /><br />Overall, the message was that effective care for patients with chronic pain and addiction requires trauma-informed, multimodal, patient-centered treatment rather than a single-medication solution.

Keywords

co-occurring pain disorders

addiction medicine

chronic pain

substance use disorders

reciprocal model

multimodal care

PEG scale

nociceptive pain

neuropathic pain

nociplastic pain

buprenorphine

methadone

pain psychology

behavioral therapy