SAN ANTONIO — To treat opioid addiction, clinicians must implement behavioral interventions in addition to medication-assisted treatments, according to Thomas Kosten, MD, of Baylor College of Medicine.
“Treating chronic pain for more than 3 months with opiates, particularly benign chronic pain — low back pain, fibromyalgia, headaches — these are the kinds of things that lead to opiate dependence but do not product sustained analgesic effects,” Kosten told Healio.com/Psychiatry. “In fact, over time they produce hyperalgesia.”
Hyperalgesia occurs in approximately 50% of patients with opiate dependence and worsens pain, according to Kosten.
Behavioral interventions are an important part of managing opioid addiction, as psychiatric conditions can be a contributing factor to opioid dependence.
Kosten emphasized the benefits of methadone maintenance, naltrexone maintenance and buprenorphine for opioid addiction and the serious harms of fentanyl.