Podcast 514: Pain Control While on Naltrexone

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