A Resident Workshop Dealing With the DrugAddicted Pain Patient

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A Resident Workshop Dealing With the
Drug-Addicted Pain Patient
Neil J. Farber, MD, FACP. Tabassum Salam, MD
Christiana Care Health System Wilmington, DE
Abstract
Dealing with the strong emotions and
manipulative behavior often exhibited by the
drug-addicted pain patient can be troubling.
While palliation of a patients pain needs to be
addressed, the drug-addicted patient must be
approached by a combination of limit-setting and
an empathic approach to their difficulties. We
designed a 2 hour workshop for residents in an
internal medicine residency program in order to
address these patients problems. All
residents in our categorical and preliminary
internal medicine, medicine/pediatrics, and
medicine/emergency medicine residency programs
will be offered this workshop. The two hour
workshop will begin with a learner-centered
learning approach, asking residents to delineate
their problems in dealing with drug-addicted pain
patients, and then what strategies they have used
to successfully or unsuccessfully deal with these
patients. A didactic portion of the workshop
will follow, with residents being informed of the
policies of the resident clinic in which they
practice, and aspects of setting limits and
finding alternative approaches to pain.
Residents will then have an opportunity to role
play dealing with such patients. After feedback
is elicited, aspects of emotions in patients and
ourselves, and the definition of limbic resonance
will be explored. Information on the empathic
approach to the patient will be given, followed
by a repeat role play. Residents perceived
confidence and comfort in dealing with the
drug-addicted pain patient will be assessed via a
validated survey before and after the
intervention. Data will be presented. A
role play workshop along with information on both
limit-setting and an empathic approach to the
patient may improve residents comfort and
confidence in dealing with the drug-addicted pain
patient.