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The Sickle Cell Disease Channel on VJHemOnc is an independent medical education platform, supported with funding from Agios (Gold). Supporters have no influence on the production of content. The levels of sponsorship listed are reflective of the amount of funding given.
ASCAT 2024 | Unanswered questions in SCD pain management: chronic opioid use and the risk of substance abuse
Wally Smith, MD, Virginia Commonwealth University, Richmond, VA, discusses the current challenges in understanding the role of opioids in managing chronic pain in patients with sickle cell disease (SCD). Prof. Smith highlights the well-established use of opioids for acute pain but notes uncertainty regarding their long-term use, particularly in managing patients who may develop substance abuse while still experiencing chronic pain. This interview took place at the 19th Annual Scientific Conference of the Academy for Sickle Cell and Thalassaemia (ASCAT 2024) in London, UK.
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Transcript
Right now the big unanswered question is what is the place of opioids in the management of chronic pain and sickle cell disease. We know the place of opioids in the management of acute pain but we don’t know whether a trial of opioids should last for 12 weeks and then you should stop or whether there’s patients who would benefit from opioids so much that it’s worth the risk to keep them on for the rest of their life...
Right now the big unanswered question is what is the place of opioids in the management of chronic pain and sickle cell disease. We know the place of opioids in the management of acute pain but we don’t know whether a trial of opioids should last for 12 weeks and then you should stop or whether there’s patients who would benefit from opioids so much that it’s worth the risk to keep them on for the rest of their life. We don’t know what to do with those very, very few patients who get on opioids and get hooked in a bad way and develop substance abuse. How do you manage those? They still have pain. They still have chronic pain. They still have sickle cell disease and now they have a new problem. Very few patients, by the way, but we don’t know what to do with those patients and we’re still learning.
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Disclosures
Advisory board: Pfizer, Agios; DSMB: Novo Nordisk, Novartis.
