Opioids Hurt Some Patients More – Here’s Who

Transcript

Dr. Takem and Dr. Tiffany Russ delve into effective strategies for managing chronic pain, exploring the complexities of opioid use, alternative therapies, and the importance of individualized care in improving patient outcomes.

In this episode, I talk with pain specialist Dr. Tiffany Russ about the tightrope of treating chronic pain while avoiding opioid harm. I share the story of an 83-year-old patient whose severe arthritis and spine disease were managed with only ibuprofen, mainly because of fear around prescribing. Dr. Russ and I break down why chronic pain is personal and subjective, why older patients shouldn’t be undertreated, and when opioids may still be appropriate, including cancer-related pain and select chronic conditions. We also clarify the difference between tolerance and addiction, and how I monitor safety with tools like PDMP checks and urine screening. We close with practical red flags for misuse, the risks of dose escalation, and why a multi-modal plan and a supportive, accountable care network matter.

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