Referral to an appropriate specialist is one of the most productive means of aiding in the care of chronic pain patients who present to the ED. Chronic pain clinics have been successful at changing the lives of patients by eliminating opioid use, decreasing medication use by two-thirds, and pain levels by one-third, and increasing work hours twofold.18 Patients' compliance with pain clinics may improve if the benefits are explained. The Canadian health system has initiated a chronic pain registry.19 Patients are referred to the registry if they have had ten or more pain-related visits to the ED in a 12-month period or by the discretion of an emergency physician. An independent third-party consultation with a chronic pain specialist is provided. The success of the system is being assessed.
Admission to the hospital is rarely indicated for chronic pain patients. However, occasionally patients may be admitted for pain control, possibly using self-controlled analgesic administration.
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