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The patient with substance use disorder

Anitescu, Magdalena

Current Opinion in Anesthesiology: June 2019 - Volume 32 - Issue 3 - p 427–437
doi: 10.1097/ACO.0000000000000738
ANESTHESIA AND MEDICAL DISEASE: Edited by John E. Ellis
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Purpose of review The purpose of this review is to describe the anesthesiologist's perioperative challenges when caring for the patient with substance use disorder and, in particular, opioid use disorder.

Recent findings With the introduction of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, psychiatric literature recently changed the criteria for defining substance use disorder. In patients with known opioid use disorder, who are undergoing elective surgery and also on maintenance therapy, use of multimodal analgesia is essential to treat postoperative pain.

Summary Patients with substance use disorders and, in particular, those addicted to opioids, present a challenge to the anesthesiologist. Whether the diagnosis of substance use disorder is known or unknown and whether on maintenance therapy, in withdrawal, or remission, patients with this condition represent a special surgical population whose perioperative care can influence their postoperative and disease course for many years.

Department of Anesthesia and Critical Care, Division of Pain Management, University of Chicago Medical Center, Illinois, USA

Correspondence to Magdalena Anitescu, MD, PhD, Department of Anesthesia and Critical Care, Division of Pain Management, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 4028, IL 60637, USA. e-mail: manitescu@dacc.uchicago.edu

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