Pain Management in Individuals With Intellectual Disabilities

Individuals with intellectual disabilities are more at risk for various causes of pain, associated with their congenital anomalies such as cardiac defects, but also later in life with dental problems and gastroesophageal reflux disease. General recommendations to develop a pain treatment strategy will be shared, especially since it is known that physicians tend to prescribe sub-therapeutic doses of analgesics to individuals with intellectual disabilities. Attention should be given to multimodal interventions, which includes pharmacological and non-pharmacological treatments. Epilepsy is a common comorbidity in intellectual disability and the drug-drug interactions will be discussed. Results from pharmacokinetic and pharmacodynamic studies on pain management in intellectually disabled individuals will be presented. Given the complexity of pain in the intellectual disability population, effective pain management requires a multidimensional approach and continuous reassessment to ensure a focus on quality of life indicators and not just reduction of pain. In addition, relevant individuals such as family/caregivers and the individual with intellectual disability themselves should be included in the assessment, management, and evaluation.