Podiatric Problems and Management in Patients with Substance Abuse

Patients typically seek treatment from a podiatric surgeon to relieve pain, whether acute from a traumatic event or chronic from long-standing or unaddressed pathology. When conservative treatment fails to provide patient satisfaction, surgical intervention becomes necessary and the surgeon must then be prepared to address acute postsurgical pain, which can be more challenging in patients with a history of substance abuse. Through meticulous surgical technique, understanding lower extremity pathomechanics, and employing sufficient perioperative analgesia, we can provide superb outcomes for our patients and prevent chronic postsurgical pain. Furthermore, there exist a variety of signs and symptoms about the foot and ankle that may indicate substance abuse when correlated with the patient’s history, and it is imperative for the podiatric surgeon to have an awareness of these clinical presentations to provide the best possible treatment.