Acute pain management for patients receiving maintenance methadone or buprenorphine therapy

The number of patients with opioid addiction who receive opioid agonist therapy (OAT) with methadone and buprenorphine is increasing, so that physicians will more frequently encounter such patients who have acutely painful conditions. This paper acknowledges the complex interplay among addictive disease, OAT, and acute pain management; describes 4 misconceptions that lead to suboptimal treatment of acute pain; and gives clinical recommendations for providing analgesia when a patient receiving OAT develops acute pain