Oct 30, 2019
Author: Don Stader, MD
Educational Pearls:
- Suboxone, methadone, and naltrexone are commonly used as treatments for opiate use disorder.
- Naltrexone is a full mu-opiate receptor antagonist, making acute pain control difficult in patients taking it.
- Options for pain control in patients on naltrexone include nerve blocks, NSAIDS, ketamine, and high doses of opiates.
- Of the opiates, Dilaudid (hydromorphone) has the highest affinity for mu-opiate receptors, and will be the most effective.
References
Vickers AP, Jolly A. Naltrexone and problems in pain management. BMJ. 2006;332(7534):132–133. doi:10.1136/bmj.332.7534.132
Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD