We have to trust the patient. Pain is undertreated. Inadequate treatment has adverse consequences. Over and under treatment are both liabilities. Opioid-maintained patients do experience pain. These patients report higher pain scores. They experience both opioid tolerance and hyperalgesia. They are responsive to opioid analgesia. They need baseline opioids ("opioid debt"), mostly a well-stabilized OST. They require higher doses, more frequent dosing and longer opioid administration.
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