HEALTH Published June 22, 2023 7:39pm EDT Addiction complicates pain management, but new guidelines offer help for ‘complex patients’

Opioids are often prescribed for pain management after surgery — but for the 19 million people in the U.S. with a history of substance abuse, that option may not be safe or desired. That is why some doctors are recommending to better use cbd gummies for pain that could potentially help alleviate pain after surgery due to their anti-inflammatory and analgesic (pain-relieving) properties. Studies have shown that CBD can reduce both acute and chronic pain, making it a potential alternative to traditional pain medications.

Until now, there hasn’t been a cohesive set of guidelines for managing surgical pain in patients with a history of addiction and/or opioid tolerance.

To address this, the American Society of Anesthesiologists (ASA) gathered 15 medical organizations representing over 500,000 physicians to develop seven guiding principles to improve pain management before, during and after surgery for these patients.

The guidelines have been published in the Regional Anesthesia & Pain Medicine journal.


Dr. David Dickerson, an anesthesiologist and pain specialist at North Shore University Hospital in Chicago, Illinois, is chair of the American Society of Anesthesiologists’ Committee on Pain Medicine. (ASRA is the American Society of Regional Anesthesia and Pain Medicine.)

“Patients with these complex issues may require additional care after surgery,” Dickerson told Fox News Digital.

Woman upset in hospital
Opioids are often prescribed for pain management after surgery — but for the 19 million people in the U.S. with a history of substance abuse, that may not be a safe or desired option. Now, a new set of guidelines may help. (iStock)

“When someone undergoes a surgical procedure and they have a substance use disorder, chronic pain or pre-operative opioid tolerance, their nervous system is different,” he told Fox News Digital in an interview.

“Their ability to self-soothe in the face of injury or pain is also going to be a very different experience.”


As the director of four hospitals, Dickerson sees patients with many different types of pain in many different care environments. It’s why he’s calling for adopting a unified approach for patients who may not have a straightforward experience with pain management when it comes to surgery, injury, trauma or disease.

“Their ability to self-soothe in the face of injury or pain is also going to be a very different experience.”

“We want to make sure the patient has a consistent experience in terms of getting pain alleviated and also minimizing the risks of pain treatments,” he said.

Over a span of several years, Dickerson and other pain management specialists and physicians crafted the following seven principles to use as a “north star” for screening, treating and educating these vulnerable patients, while building awareness and education for safe and effective surgical care.

1. Identify patients at risk
Physicians should “screen for substance abuse preoperatively, risk stratify and refer for treatment as needed,” the first principle states.

The doctor should speak with the patient prior to surgery to determine whether there is any history of substance abuse, identify any risk factors and provide recommendations for referrals as needed.

“Clinicians should identify patients with a substance use disorder and facilitate evaluation and treatment before surgery.”

“As the majority of patients receive a post-surgery opioid prescription and 100,000 Americans die annually from accidental opioid overdose, clinicians should identify patients with a substance use disorder and facilitate evaluation and treatment before surgery,” Dickerson told Fox News Digital.

“Identifying and treating substance use disorders saves lives — especially when we recognize that 19 million Americans have at least one substance use disorder.”

2. Coordinate care for complex patients
“Coordinate care pre-operatively for complex patients and consult with pain medicine, behavioral health or addiction medicine specialists to optimize the treatment plan,” the second principle states.

It’s also important to note that CBD gummies should not be used as a substitute for medical treatment and recovery after surgery. but this is a good option for patients to alleviate pain.

5 Responses

  1. psss,,,As i read that,look at all the new $$$ for addiction psychiatry,,ie a addiction specialist=$$$, a substance use specialists =new $$$,Behavorial health specialist=new $$$$,None these new $$$$ position were ever there prior to kolodny/balltyne kaiser forced coercive tactics of forcible combining psychiatry ,the mental w/the medical,and it was FORCIBLE DONE!!! Here is the reality,like it or not,,prior to A.k.,,J.B.. and all his prop people forced there way into MEDICAL CARE,,PSYCHIATRY,, went after,,the sick,the dying,the medically ill in physical pain,,the WEAKEST in our society,those who thru no choice are medically afflicted,went after the weakest,the sick in physical pain FOR A PROFIT,, because the sick,the dying can’t defend themselves,,get this strait,,addiction psychiatry went after the weakest in society to profit off of,,,even if it meant literally being tortured to death,,,
    $$$$$$$$ was more important to them,,and because of their $$$$$$$,and their demented mind off profits off of the weakest by torturing them,,,only a handful of men/women stood up for what was right,what was humane,,which is NOT going after the weakest,the sick the dying,,its not humane nor a humane society that allows this to happen,,,but it has,,,Our government was suppose to protect us,,not kill us,,but they too saw $$$$$,,a profit off of the weakest in our society,,THEIR WRONG FOLKS,,, anyone who goes after the weakest,the sick,the dying for profit,,should be charged w/torture,,locked up for lifge,soo they never willfully harm society again,for that is exactly what they did,,,,jmo,,maryw

  2. Again,i was specifically told by my doctor,when i requested my effective dose of medicine opiates,that allowed me to function,to live life again,,he could not do that,as it would be RED DFLAGGED in the pdmp,which would get him/I in trouble,Sooooo tell me again,how the government dea is not practicing medicine when they decide how much medicine i’m allowed for my medical condition’s???Addictionist own krebbs study PROVED 90 mme crap is toooooooo low to effectively lessen physical pain from any medical condition,yet that is what we are all forced down to,,a dose that is basically non-effective by their own study???How does that make sense??and if my doctor wants to go back to my dose that worked,he will get red flag in a system the dea watches to arrest doctors,,hows that not decideing,interefering into the practice of medicine by the DEA,, thus violation of 42-1395????maryw

  3. This tells me avoid surgery and hospitals!!

  4. Are there more than two recommendations? I must be missing something…

  5. So. In reading this, I saw the usual gum flapping. They say arrangements should be made. That the patient’s doctor should talk to the patient. Nowhere does it say how they will TREAT these patients. Also, did I read that chronic pain patients are…lumped in with addicts?
    Someone clarify for me, please.

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