The Curbsiders Internal Medicine Podcast #487 Chronic Pain & Opioid Use Disorder with Dr. Jessie Merlin
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Jun 16, 2025 Dr. Jessica Merlin, a professor at the University of Pittsburgh and expert in addiction medicine, shares invaluable insights on managing chronic pain among patients with opioid use disorder. She busts myths surrounding pain management and emphasizes the necessity for integrated care approaches. The conversation highlights the significance of behavioral interventions like cognitive therapy and mindfulness, as well as the importance of personalized treatment plans, to enhance patient outcomes and reduce stigma in this complex field.
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Chronic Pain and OUD Overlap
- Chronic pain lasts beyond normal healing for 3+ months and affects 20% of the U.S. population.
- Chronic pain and opioid use disorder often coexist and interact, requiring integrated management.
Center Patient Priorities
- Ask patients how cravings and pain overlap and focus on their priorities, often pain.
- Respect patients who prioritize pain relief even if not engaged in addiction treatment.
Assess Pain and Build Trust
- Use the PEG scale to assess pain severity and impact on life functions.
- Screen for pain systematically in addiction settings and build trust by acknowledging stigma.