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Topic 6 – Pain Management and Problematic Substance Use

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Not all individuals who are prescribed pain medication develop problematic use despite sometimes becoming physically dependent on the medication.

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Problematic use includes physical dependence, plus:

  • Behaviours that include spending time sourcing more of the substance
  • Using to avoid withdrawal symptoms
  • Continued use despite negative consequences
  • Not meeting responsibilities
  • Harm to health and relationships.


Individuals who develop a physical dependence need to be under a doctor’s care to stop taking the medication. Individuals who have substance use problems, current or historic, and require pain medication, may need to be supported closely so as not to retrigger or exacerbate a pre-existing vulnerability to problematic use.

It is important that individuals with problematic substance use not be seen as merely ‘drug seeking’ when presenting with pain issues. Pain can cause needless suffering. People have a right to have their pain addressed.

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