Podcast 514: Pain Control While on Naltrexone 

Author: Don Stader, MD Educational Pearls: Suboxone, methadone, and naltrexone are commonly used as treatments for opiate use disorder.  Naltrexone is a full mu-opiate receptor antagonist, making acute pain control difficult in patients taking it.  Options for pain control in patients on naltrexone include nerve blocks, NSAIDS, ketamine, and high doses of opiates.  Of the opiates, Dilaudid (hydromorphone) has the highest affinity for mu-opiate receptors, and will be the most effective. References Vickers AP, Jolly A. Naltrexone and problems in pain management. BMJ. 2006;332(7534):132–133. doi:10.1136/bmj.332.7534.132   Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD