Author(s): Lacy A. Fabian, Meridith H Thanner and Katherine Kim
Chronic pain is one of the most widespread and costly complaints facing healthcare today. In developing appropriate care plans for managing chronic pain it is critical to adequately assess risk factors that may alter the course of care. Notably, addiction operates along many of the same pathways as pain and can serve as a moderating factor in caring for those in pain (i.e., considering medications to prescribe for the management of pain in those with an active addiction) or a mediating factor whereby a new addiction develops in the course of managing the pain. This review examines addiction risk assessment tools specifically in the realm of alcohol, opioid use, and tobacco, which can be used in developing chronic pain care plans. Though the importance of assessing risk factors associated with addiction is well recognized, given the implications for the management of chronic pain, the means for adequately utilizing the assessments are limited by a lack of standardization and even barriers in the healthcare setting, such as time with which to perform the assessments. Efforts to develop psychometrically strong risk assessments tailored for use in various healthcare settings that allow for stratification into levels of risk and also employ strategies beyond mere subjective self-report are needed. As pain is such a prevalent experience and is considered a vital sign of health status, appropriate pain management is critical to managing healthcare costs and preventing undue stress on individuals, particularly those with various addictions.
