Tata Laksana Nyeri Kronik Pada Pasien Adiksi

Substance-abuse has been a huge problem with 5.6% percent prevalence around the world. Based on surveys held by Badan Narkotika Nasional (BNN), approximately three thousand people aged 15-64 years old have tried to use drugs with 16.000 of them have gone to addiction state. The addiction state may cause physiological changes based on its duration, such as behavioral changes, social dysfunction, and also neurotransmitters activity in the synapse which cause the reward pathways dysfunction. Furthermore, addiction state may cause tolerance and withdrawal syndrome for its substance, especially opioids, which affect the treatment of chronic pain in this group. Therefore, clinicians have to recognize and give appropriate chronic pain treatment to patients with addiction. Based on literature searching, the chronic pain treatment for patients with addiction can be done by giving multidisciplinary pain treatment, start with pharmacological, physical, psycho-behavioral, and also with interventional treatment. The pharmacological treatment that can be used for this group consists of opioids, non-steroidal anti-inflammation drugs (NSAID), anticonvulsants, antidepressants, and anesthesia agents. The special consideration for opioids usage for this group is that the tolerance, withdrawal, and complications caused by the addiction state. Thus, the combination of long-acting and short-acting opioids with appropriate doses are preferable. The combination of non-opioid with non-opioid drugs and other options for Chronic Pain treatment such as physical treatment will also give good results.