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Fink! Still at Large : A study of patients prescribed opioids for chronic pain showed that psychiatric factors can raise the risk of misuse. What has been your treatment approach in helping these patients?


 

In psychiatry, we have two subspecialties that should be fully accepted not only by medicine as a whole and the public but by psychiatrists as well. These are addiction psychiatry and pain medicine. The former is older and better defined. As this column makes clear, this specialty needs to be better understood and incorporated into the full practice of psychiatry with appropriate knowledge of the field as well as the use of trained colleagues to help us navigate what is a significant part of our specialty. This is especially the case in light of the serious problems of dual diagnosis patients and the ever growing problem of prescription drug abuse among teenagers and young adults in our country.

Pain medicine, which is shared with anesthesiology, oncology, neurology, and a raft of specialties outside of medicine (in particular hypnotism), is a growing field. We need to understand this field better so that we can do a better job of treating patients who are in pain and are addicted, and also have a psychiatric disorder. Addiction psychiatry and pain medicine truly demonstrate the complexity of our work as psychiatrists.

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