Palliative care symposium: promoting joint palliative care.

Dr Lesley Colvin (Senior Lecturer in Anaesthesia, Western General Hospital, Edinburgh) discussed the challenges of pain management in patients with a history of addiction. Similar to other chronic conditions, substance misuse often follows a relapsing course. Pain is a frequently associated comorbidity. Mortality rates are high but can be reduced by successful methadone maintenance programmes, although pain, anxiety and depression have a negative effect on outcomes. Dr Colvin described experience of the Lothian Pain and Dependency Clinic. General guidance on patient management is available through the British Pain Society Guidelines.