Would you prescribe pain meds to a prior drug addict if they need them for a car injury from two years ago?

Tough question!: Some medications aren't addicting so i'd recommend starting there first. Also, i'd be concerned about why pain persists 2yrs after injury. Addicting opioids aren't useful for neuropathic pain nor for causalgia (complex regional pain syndrome): check out http://www.Mayoclinic.Com/health/complex-regional-pain-syndrome/ds00265. I think this would be perfect case for pain specialist to oversee.

Yes: I would use a multi-modal regimen that would specifically exclude use of opiod containing medications.

Yes: However, as I have a Suboxone license that would be my first choice because addicts on it rarely escalate the dose and it is an excellent pain reliever. Pain management physicians should, however be consulted first as they have many other options to offer first.

Pain in the addict : Abuse risk is higher when treating a patient with prior drug addiction. With that having been said, a patient with prior history of addiction shouldn't be precluded from receiving appropriate pain management. Non-habit forming meds, non-medicinal modalities & various injection types can be tried. In the rare event narcotics are needed a strict pain-psych team can work with you in hopes of best.