Medication Approaches

Although some patients and families prefer to avoid medication approaches, many expect medications to manage pain. Families need to have correct information regarding the expected benefits and risks associated with medication options. The mental health consultant is in a position to provide this education within the larger context of cognitive-behavioral and body-based pain management approaches.

Mental health consultants are most frequently asked for pain medication recommendations when standard medication approaches are ineffective, when pain is considered unexplained or "psychological" by the primary team, or when pain is associated with high levels of distress or obvious psychiatric symptoms. Consequently, mental health consultants are most likely to recommend adjuvant medications and/or target comorbidities. The reader is referred to Chapter 30 for a more thorough review of psycho-pharmacology. Depending on the sophistication of the primary team treating an individual's pain, the mental health consultant may need to determine if first-line medications have been used appropriately.

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