Acute pain and substance abuse in surgical patients.

Studies have determined that nurses and physicians undermedicate patients for postoperative pain as a result of inadequate knowledge and erroneous attitudes. Fear of addiction seems to be the major reason for this undertreatment. A patient who abuses drugs requires larger than usual doses of narcotics postoperatively; however, larger doses are rarely given. This article emphasizes factors influencing the postoperative pain experience and presents 3 case studies to illustrate pain management in patients who abuse substances.