Misuse of and dependence on opioids: study of chronic pain patients
To review the evidence on identifying and managing misuse of and dependence on opioids among primary care patients with chronic pain. MEDLINE was searched using such terms as "opioid misuse" and "addiction." The few studies on the prevalence of opioid dependence in primary care p...
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| Veröffentlicht in: | Canadian family physician 2006-09, Vol.52 (9), p.1081-1081 |
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| container_title | Canadian family physician |
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| creator | Kahan, Meldon Srivastava, Anita Wilson, Lynn Gourlay, Douglas Midmer, Deana |
| description | To review the evidence on identifying and managing misuse of and dependence on opioids among primary care patients with chronic pain.
MEDLINE was searched using such terms as "opioid misuse" and "addiction." The few studies on the prevalence of opioid dependence in primary care populations were based on retrospective chart reviews (level II evidence). Most recommendations regarding identification and management of opioid misuse in primary care are based on expert opinion (level III evidence).
Physicians should ask all patients receiving opioid therapy about current, past, and family history of addiction. Physicians should take "universal precautions" that include careful prescribing and ongoing vigilance for signs of misuse. Patients suspected of opioid misuse can be treated with a time-limited trial of structured opioid therapy if they are not acquiring opioids from other sources. The trial should consist of daily to weekly dispensing, regular urine testing, and tapering of doses of opioids. If the trial fails or is not indicated, patients should be referred for methadone or buprenorphine treatment.
Misuse of and dependence on opioids can be identified and managed successfully in primary care. |
| format | Article |
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MEDLINE was searched using such terms as "opioid misuse" and "addiction." The few studies on the prevalence of opioid dependence in primary care populations were based on retrospective chart reviews (level II evidence). Most recommendations regarding identification and management of opioid misuse in primary care are based on expert opinion (level III evidence).
Physicians should ask all patients receiving opioid therapy about current, past, and family history of addiction. Physicians should take "universal precautions" that include careful prescribing and ongoing vigilance for signs of misuse. Patients suspected of opioid misuse can be treated with a time-limited trial of structured opioid therapy if they are not acquiring opioids from other sources. The trial should consist of daily to weekly dispensing, regular urine testing, and tapering of doses of opioids. If the trial fails or is not indicated, patients should be referred for methadone or buprenorphine treatment.
Misuse of and dependence on opioids can be identified and managed successfully in primary care.</description><identifier>ISSN: 0008-350X</identifier><identifier>EISSN: 1715-5258</identifier><identifier>PMID: 17279218</identifier><language>eng</language><publisher>Canada: The College of Family Physicians of Canada</publisher><subject>Analgesics, Opioid - adverse effects ; Analgesics, Opioid - therapeutic use ; Canada - epidemiology ; Chronic Disease ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug and Narcotic Control ; Drug Monitoring ; Drug Utilization ; Education, Medical, Continuing ; Family Practice - standards ; Family Practice - trends ; Female ; Humans ; Incidence ; Male ; Opioid-Related Disorders - epidemiology ; Opioid-Related Disorders - etiology ; Opioid-Related Disorders - physiopathology ; Pain - diagnosis ; Pain - drug therapy ; Physician's Role ; Risk Assessment ; Severity of Illness Index ; Substance Abuse Detection - methods</subject><ispartof>Canadian family physician, 2006-09, Vol.52 (9), p.1081-1081</ispartof><rights>Copyright © 2006, Can Fam Physician 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1783735/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1783735/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17279218$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kahan, Meldon</creatorcontrib><creatorcontrib>Srivastava, Anita</creatorcontrib><creatorcontrib>Wilson, Lynn</creatorcontrib><creatorcontrib>Gourlay, Douglas</creatorcontrib><creatorcontrib>Midmer, Deana</creatorcontrib><title>Misuse of and dependence on opioids: study of chronic pain patients</title><title>Canadian family physician</title><addtitle>Can Fam Physician</addtitle><description>To review the evidence on identifying and managing misuse of and dependence on opioids among primary care patients with chronic pain.
MEDLINE was searched using such terms as "opioid misuse" and "addiction." The few studies on the prevalence of opioid dependence in primary care populations were based on retrospective chart reviews (level II evidence). Most recommendations regarding identification and management of opioid misuse in primary care are based on expert opinion (level III evidence).
Physicians should ask all patients receiving opioid therapy about current, past, and family history of addiction. Physicians should take "universal precautions" that include careful prescribing and ongoing vigilance for signs of misuse. Patients suspected of opioid misuse can be treated with a time-limited trial of structured opioid therapy if they are not acquiring opioids from other sources. The trial should consist of daily to weekly dispensing, regular urine testing, and tapering of doses of opioids. If the trial fails or is not indicated, patients should be referred for methadone or buprenorphine treatment.
Misuse of and dependence on opioids can be identified and managed successfully in primary care.</description><subject>Analgesics, Opioid - adverse effects</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Canada - epidemiology</subject><subject>Chronic Disease</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Drug and Narcotic Control</subject><subject>Drug Monitoring</subject><subject>Drug Utilization</subject><subject>Education, Medical, Continuing</subject><subject>Family Practice - standards</subject><subject>Family Practice - trends</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Opioid-Related Disorders - epidemiology</subject><subject>Opioid-Related Disorders - etiology</subject><subject>Opioid-Related Disorders - physiopathology</subject><subject>Pain - diagnosis</subject><subject>Pain - drug therapy</subject><subject>Physician's Role</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Substance Abuse Detection - methods</subject><issn>0008-350X</issn><issn>1715-5258</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1LxDAQhoMo7rr6F6Qnb4V8dlIPgiy6CiteFLyFbJJuI92kNK1l_72VVdHLDMz7zDMwR2hOgIhcUCGP0RxjLHMm8NsMnaX0jjEtOCOnaEaAQkmJnKPlk09DclmsMh1sZl3rgnXBTJOQxdZHb9N1lvrB7r8YU3cxeJO12oep9N6FPp2jk0o3yV189wV6vb97WT7k6-fV4_J2nW8ZxX3uKgsWpGa84kwIyjQpLCacbwRQIgwGqg2AwFCWHBxIy3VBnSm5BINlxRbo5uBth83OWTPd7nSj2s7vdLdXUXv1Pwm-Vtv4oQhIBkxMgsu_gt_Nn3dMwNUBqP22Hn3nVNrppplwqsZxFFSVimBJ2Ccel2qU</recordid><startdate>20060901</startdate><enddate>20060901</enddate><creator>Kahan, Meldon</creator><creator>Srivastava, Anita</creator><creator>Wilson, Lynn</creator><creator>Gourlay, Douglas</creator><creator>Midmer, Deana</creator><general>The College of Family Physicians of Canada</general><general>College of Family Physicians of Canada</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>5PM</scope></search><sort><creationdate>20060901</creationdate><title>Misuse of and dependence on opioids: study of chronic pain patients</title><author>Kahan, Meldon ; Srivastava, Anita ; Wilson, Lynn ; Gourlay, Douglas ; Midmer, Deana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g320t-efd7d78a34f435523a16d0144b57215c072ac775079947e78d4a62ec9487c08f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Analgesics, Opioid - adverse effects</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Canada - epidemiology</topic><topic>Chronic Disease</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Drug and Narcotic Control</topic><topic>Drug Monitoring</topic><topic>Drug Utilization</topic><topic>Education, Medical, Continuing</topic><topic>Family Practice - standards</topic><topic>Family Practice - trends</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Opioid-Related Disorders - epidemiology</topic><topic>Opioid-Related Disorders - etiology</topic><topic>Opioid-Related Disorders - physiopathology</topic><topic>Pain - diagnosis</topic><topic>Pain - drug therapy</topic><topic>Physician's Role</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Substance Abuse Detection - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kahan, Meldon</creatorcontrib><creatorcontrib>Srivastava, Anita</creatorcontrib><creatorcontrib>Wilson, Lynn</creatorcontrib><creatorcontrib>Gourlay, Douglas</creatorcontrib><creatorcontrib>Midmer, Deana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Canadian family physician</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kahan, Meldon</au><au>Srivastava, Anita</au><au>Wilson, Lynn</au><au>Gourlay, Douglas</au><au>Midmer, Deana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Misuse of and dependence on opioids: study of chronic pain patients</atitle><jtitle>Canadian family physician</jtitle><addtitle>Can Fam Physician</addtitle><date>2006-09-01</date><risdate>2006</risdate><volume>52</volume><issue>9</issue><spage>1081</spage><epage>1081</epage><pages>1081-1081</pages><issn>0008-350X</issn><eissn>1715-5258</eissn><abstract>To review the evidence on identifying and managing misuse of and dependence on opioids among primary care patients with chronic pain.
MEDLINE was searched using such terms as "opioid misuse" and "addiction." The few studies on the prevalence of opioid dependence in primary care populations were based on retrospective chart reviews (level II evidence). Most recommendations regarding identification and management of opioid misuse in primary care are based on expert opinion (level III evidence).
Physicians should ask all patients receiving opioid therapy about current, past, and family history of addiction. Physicians should take "universal precautions" that include careful prescribing and ongoing vigilance for signs of misuse. Patients suspected of opioid misuse can be treated with a time-limited trial of structured opioid therapy if they are not acquiring opioids from other sources. The trial should consist of daily to weekly dispensing, regular urine testing, and tapering of doses of opioids. If the trial fails or is not indicated, patients should be referred for methadone or buprenorphine treatment.
Misuse of and dependence on opioids can be identified and managed successfully in primary care.</abstract><cop>Canada</cop><pub>The College of Family Physicians of Canada</pub><pmid>17279218</pmid><tpages>1</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0008-350X |
| ispartof | Canadian family physician, 2006-09, Vol.52 (9), p.1081-1081 |
| issn | 0008-350X 1715-5258 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1783735 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Analgesics, Opioid - adverse effects Analgesics, Opioid - therapeutic use Canada - epidemiology Chronic Disease Dose-Response Relationship, Drug Drug Administration Schedule Drug and Narcotic Control Drug Monitoring Drug Utilization Education, Medical, Continuing Family Practice - standards Family Practice - trends Female Humans Incidence Male Opioid-Related Disorders - epidemiology Opioid-Related Disorders - etiology Opioid-Related Disorders - physiopathology Pain - diagnosis Pain - drug therapy Physician's Role Risk Assessment Severity of Illness Index Substance Abuse Detection - methods |
| title | Misuse of and dependence on opioids: study of chronic pain patients |
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