Biopsychosocial Assessment for Chronic Opioid Use

Chronic daily pain continues to affect a significant portion of the American population, contributing to physical impairment, disability, and loss of function. An understanding of the multidimensional experience of pain will better prepare clinicians to more effectively assess and treat pain conditions, and to design individualized pain management therapies specific for a patient’s needs. Furthermore, appropriate assessment and treatment rely on a basic understanding of changes seen across the central nervous system, as well as psychosocial changes related to pain and suffering. A biopsychosocial approach to assessment and treatment addresses all aspects of pain and suffering and may be more easily implemented by understanding associated learned behaviors. In addition, adequate screening and ongoing monitoring based on individual characteristics are an important part of patient management. Validated assessment tools, such as the Screener and Opioid Assessment for Patients in Pain and the Opioid Risk Tool, may help screen patients being considered for long-term opioid therapy who may be at risk for engaging in aberrant behaviors. General concepts related to pain management, including theoretic models that incorporate a comprehensive view of peripheral and central nervous system changes related to chronic pain, how psychologic factors may impact pain perception and loss of function, definitions important in the clinical use of opioids, and assessment tools that may be useful in screening patients for long-term opioid management, are considered.