Management of Acute Pain Due to Traumatic Injury in Patients with Chronic Pain and Pre-injury Opioid Use

Purpose of Review This review seeks to provide a summary of recent literature to help guide practitioners in the management of acute pain due to traumatic injury in patients with chronic pain as well as with pre-injury opioid use. It also seeks to illuminate areas in need of further investigation. Recent Findings There is a paucity of professional guidelines and clinical trials on this topic, despite the disproportionate rates of preexisting opioid use and chronic pain in trauma patients, and the contributions of these issues to inferior outcomes. The management of these patients is complex, requiring knowledge of opioid conversions, medication-assisted treatment (MAT), and non-opioid analgesic options. Provider education, standardized assessments and screening tools, evolving multidisciplinary approach, careful management of pre-injury therapy, use of non-opioid adjuvant therapies, early discharge planning, and close follow-up are essential to achieving adequate acute pain control in these patients, which can contribute to better short- and long-term outcomes.