For a patient with substance dependence and chronic spinal pain, which medication is commonly recommended?

Buprenorphine and naloxone is commonly recommended for patients with substance dependence and chronic pain, particularly in cases involving opioid dependence. Buprenorphine is a partial opioid agonist, meaning it can provide pain relief while also reducing cravings and withdrawal symptoms associated with opioid dependence. When combined with naloxone, the formulation helps prevent misuse; naloxone counteracts the effects of opioids if the medication is abused.

This combination is especially beneficial in managing both pain and the risk of addiction, making it a suitable choice for patients who may have a history of substance dependence. Buprenorphine enables adequate pain control without producing the same level of euphoria as full agonist opioids, thus minimizing the risk of developing further substance use issues. In contrast, other medications listed do not directly address both chronic pain and substance dependence as effectively as buprenorphine and naloxone.