Prescription opioid abuse in chronic pain: a review of opioid abuse predictors and strategies to curb opioid abuse.
نویسندگان
چکیده
Both chronic pain and prescription opioid abuse are prevalent and continue to exact a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self medication, use for reward, compulsive use because of addiction, and diversion for profit. Treatment approaches that balance treating chronic pain while minimizing risks for opioid abuse, misuse, and diversion are much needed. The use of chronic opioid therapy for chronic noncancer pain has increased dramatically in the past 2 decades in conjunction with a marked increase in the abuse of prescribed opioids and accidental opioid overdoses. Consequently, a validated screening instrument that provides an effective and rational method of selecting patients for opioid therapy, predicting risk, and identifying problems once they arise could be of enormous benefit. Such an instrument could potentially curb the risk of iatrogenic addiction. Although several screening instruments and strategies have been introduced in the past decade, there is no single test or instrument that can reliably and accurately predict patients who are not suitable for opioid therapy or identify those who need increased vigilance or monitoring during therapy. At present screening for opioid abuse includes assessment of premorbid and comorbid substance abuse; assessment of aberrant drug-related behaviors; risk factor stratification; and utilization of opioid screening tools. Multiple opioid assessment screening tools and instruments have been developed by various authors. In addition, urine drug testing, monitoring of prescribing practices, prescription monitoring programs, opioid treatment agreements, and utilization of universal precautions are essential. Presently, a combination of strategies is recommended to stratify risk, identify and understand aberrant drug related behaviors, and tailor treatments accordingly. This manuscript will review the current state of knowledge regarding the growing problem of opioid abuse and misuse; known risk factors; and methods of predicting, assessing, monitoring, and addressing opioid abuse and misuse in patients with chronic noncancer pain.
منابع مشابه
Prescription Opioid Abuse in Chronic Pain: An Updated Review of Opioid Abuse Predictors and Strategies to Curb Opioid Abuse: Part 1.
Chronic pain and prescription opioid abuse are extremely prevalent both in this country and worldwide. Consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of ...
متن کاملPrevention of opioid abuse in chronic non-cancer pain: an algorithmic, evidence based approach.
BACKGROUND The use of opioids for chronic non-cancer pain has grown exponentially in the last 15 years. Associated with that, dramatic increases in abuse and overdose deaths from opioid use have been noted. OBJECTIVES Most opioid abuse stems from legitimate prescriptions, putting the onus on prescribers to use opioids responsibly for chronic pain. Very little evidence-based guidance exists fo...
متن کاملRisk factors for clinically recognized opioid abuse and dependence among veterans using opioids for chronic non-cancer pain.
A central question in prescribing opioids for chronic non-cancer pain (CNCP) is how to best balance the risk of opioid abuse and dependence with the benefits of pain relief. To achieve this balance, clinicians need an understanding of the risk factors for opioid abuse, an issue that is only partially understood. We conducted a secondary data analysis of regional VA longitudinal administrative d...
متن کاملA Comparative Study on the Personality Traits of Opioid- Dependents with and without Somatic Chronic Pain Complaints
Background & Aims: Some people use opioid substances to relief their chronic somatic pains. There are differences in the personality traits of this individuals and others who abuse opioid substances. The purpose of the present study was to compare these two groups in regard to their personality traits and disorders. Methods: In a cross-sectional study between 2007 to 2011, all patients refer...
متن کاملOpioid Abuse in the Emergency Department
Background T he last decade has witnessed a dramatic shift in the perception of the safety of opioid prescribing. An initial analysis by the Pain and Policy Studies Group at the University of Wisconsin Medical School1 concluded that the use of opioids in the chronic pain population carried a low risk of abuse potential. They had studied the national utilization of five opioid analgesics used to...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Pain physician
دوره 15 3 Suppl شماره
صفحات -
تاریخ انتشار 2012