Case Series: The Use and Misuse of Intrathecal Pain Pumps

Background Targeted Drug Delivery (TDD), also known as an intrathecal “pain pump,” utilizes a pump and catheter to administer opioid medications for treatment of chronic pain. Given the bidirectional link between chronic pain and mental health conditions, patients with chronic pain are at increased likelihood of presenting to a psychiatrist. As such, it is useful for psychiatrists to understand these pumps, as well as the potential for misuse. Methods We present two case reports of TDD misuse observed by our team and provide a brief review of the relevant literature. Results TDD is associated with unique withdrawal phenomena. Additionally, there are cases of pump misuse, and diversion is a risk. Conclusions Psychiatrists should be familiar with pain management strategies, including TDD. TDD is an innovative approach to managing chronic pain; however, it is not without risk of misuse. Psychiatrists, particularly those who specialize in treating patients with chronic pain, should be aware of the potential for misuse and potential signs of misuse.