#299 Acute Pain Management for the Hospitalist

Managing acute pain in hospitalized patients requires a multimodal approach that prioritizes patient-centered assessment and the judicious use of opioids. Dr. Melissa Weimer emphasizes that effective pain control involves addressing underlying conditions—such as visceral pain in IBD flares—while utilizing non-opioid adjuncts like acetaminophen and regional anesthesia to minimize opioid reliance. When opioids are necessary, clinicians should avoid rigid dosing schedules, instead opting for patient-controlled analgesia (PCA) or tailored tapers to prevent dependence. For patients with opioid use disorder, stabilizing cravings with methadone or buprenorphine is essential, as these treatments are not mutually exclusive with acute pain management. Ultimately, clinicians must move beyond fear-based prescribing, engaging anesthesia colleagues for advanced surgical strategies and ensuring every patient discharged on opioids receives naloxone to mitigate overdose risk.