PHM-03 - Narcotics for Nerve Pain: Is There a Role for Opioids in the Treatment of Neuropathic Pain?

The management of patients with neuropathic pain can be challenging given the complex psychosocial issues associated with chronic pain as well as Opioid Use Disorder. This lecture will review the physiological differences between neuropathic and nociceptive pain and how this directly relates to improving pharmacological mechanisms, providing practitioners with a clear algorithmic approach to medication selection for neuropathic pain. Beyond this overview, special attention is given to certain unique opioid medications which have been shown in clinical studies to be effective in treating neuropathic pain. We will review the molecular mechanisms that may underlie this surprising efficacy, in what cases these medications may actually be the preferred choice for treatment, and the use of opioids in patients with OUD and co-morbid neuropathic pain syndromes.