Background: Substance abuse in pain management can undermine treatment compliance, the effectiveness of therapies, and social support and functioning.
Material: An overview is given regarding pain management for patients on chronic use of opioids and for patients with drug dependence and substance abuse.
Results: Clinical experience as well as relevant documentation demonstrates that management of these patients remains one of the most challenging problems in clinical medicine.
Conclusion: Assessment and treatment plans for this patient group require an understanding of tolerance, physical dependence and drug abuse. It is imperative that the patient's ongoing treatment is planned in a multidisciplinary setting, so as to assure a consistent, structured and shared approach by all caregivers.