Podcast 514: Pain Control While on Naltrexone

Emergency Medical Minute · medicalminute

October 30, 20192m 6s

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Show Notes

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

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