Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2007 Jun;32(4):399-409.
doi: 10.1016/j.jsat.2006.10.005. Epub 2007 Jan 9.

Pharmacological pain control for human immunodeficiency virus-infected adults with a history of drug dependence

Sanjay Basu  1 , R Douglas Bruce, Declan T Barry, Frederick L Altice
Affiliations
Review

Pharmacological pain control for human immunodeficiency virus-infected adults with a history of drug dependence

Sanjay Basu et al. J Subst Abuse Treat. 2007 Jun.

Abstract

Clinicians treating human immunodeficiency virus (HIV)-infected patients with substance use disorders often face the challenge of managing patients' acute or chronic pain conditions while keeping in mind the potential dangers of prescription opiate dependence. In this clinical review, we critically appraise the existing data concerning barriers to appropriate treatment of pain among HIV-infected patients with substance use disorders. We then analyze published studies concerning the choice of pharmacological pain control regimens for acute and chronic pain conditions in HIV-infected patients, keeping in mind HIV-specific issues related to drug interactions and substance use disorders. We summarize this information in the form of flowcharts for physicians approaching HIV-infected patients who present with complaints of pain, providing evidence-based guidance for the structuring of pain management services and for addressing aberrant drug-taking behaviors.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Stepwise approach for acute pain. Based on information from Ballantyne (2002), Ballantyne and Mao (2003), and Gourlay et al. (2005). *See text; patients on chronic opiate substitution therapy using buprenorphine should either change the frequency of dosing or change to a full-opiate agonist during acute pain treatment; then, patients are reinduced onto buprenorphine after adequate acute pain treatment.
Fig. 2
Fig. 2
Stepwise approach for chronic pain. Based on information from Ballantyne and Mao (2003). *Equivalent dosages specified in Table 3.
See this image and copyright information in PMC

References

    1. Alford DP, Compton P, Samet JH. Acute pain management for patients receiving maintenance methadone or buprenorphine therapy. Annals of Internal Medicine. 2006;144:127–134. - PMC - PubMed
    1. Antoin H, Beasley RD. Opioids for chronic noncancer pain. Tailoring therapy to fit the patient and the pain. Postgrad Med. 2004;116(3):37–40. 43–44. - PubMed
    1. Ballantyne J. The Massachusetts General Hospital handbook of pain management. Philadelphia: Lippincott, Williams & Wilkins; 2002. p. 562.
    1. Ballantyne JC, Mao J. Opioid therapy for chronic pain. New England Journal of Medicine. 2003;349:1943–1953. - PubMed
    1. Basu S, Chwastiak LA, Bruce RD. Clinical management of depression and anxiety in HIV-infected adults. AIDS. 2005;19:2057–2067. - PubMed

Publication types

MeSH terms

Substances