Substance Use Disorders in a Primary Care Sample Receiving Daily Opioid Therapy
Journal of PainPublished 12 May 2007Open access
Michael F. Fleming, Stacey L. Balousek, Cynthia L. Klessig, Marlon P. Mundt, David D. Brown
Citations275
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TL;DR
It is found that the frequency of opioid use disorders was 4 times higher in patients receiving opioid therapy compared with general population samples and quantitative data linking aberrant drug behaviors to opioids use disorders is provided.
Abstract
This study found that the frequency of opioid use disorders was 4 times higher in patients receiving opioid therapy compared with general population samples (3.8% vs 0.9%). The study also provides quantitative data linking aberrant drug behaviors to opioid use disorders.
Keywords
MedicinePharmacology, Toxicology and Pharmaceutics
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Drug and Alcohol DependenceMajor increases in opioid analgesic abuse in the United States: Concerns and strategies
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PainOpioid pseudoaddiction — an iatrogenic syndrome
648 Citations1989David E. Weissman, J. David Haddox
The term pseudoaddiction is introduced to describe the iatrogenic syndrome of abnormal behavior developing as a direct consequence of inadequate pain management in a 17-year-old with leukemia, pneumonia and chest-wall pain.
The LancetOpioids in pain management
415 Citations1999Henry McQuay
In this review, the focus is on chronic and cancer pain, but many of the principles apply in acute pain.
Clinical Journal of PainDrug Abuse, Dependence, and Addiction in Chronic Pain Patients
357 Citations1992David A. Fishbain, Hubert L. Rosomoff +1 more
It is concluded that these diagnoses occur in a significant percentage of chronic pain patients, and there is little evidence in these studies that addictive behaviors are common within the chronic pain population.
Journal of General Internal MedicineUse of opioid medications for chronic noncancer pain syndromes in primary care
340 Citations2002M. Carrington Reid, Laura L. Engles‐Horton +4 more
A broad spectrum of chronic noncancer pain disorders are treated with opioid medications in primary care settings, and a lifetime history of a substance use disorder and decreasing age were associated with prescription opioid abuse behavior.
PainManagement of pain during debridement: a survey of U.S. burn units
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Journal of General Internal MedicinePrimary care provider concerns about management of chronic pain in community clinic populations
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Journal of Pain and Symptom ManagementScreening for Addiction in Patients with Chronic Pain and “Problematic” Substance Use
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PubMedChronic pain: treatment barriers and strategies for clinical practice.
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PainPhysicians' attitudes and practices regarding the long-term prescribing of opioids for non-cancer pain
185 Citations1994Dennis C. Turk, Michael C. Brody +1 more
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Journal of Pain and Symptom ManagementLong-term opioid therapy: Assessment of consequences and risks
177 Citations1996Seddon R. Savage
History and legislation that has shaped medical prescribing of opioids is reviewed, the potential risks and consequences of long-term opioid therapy are examined, and three models ofLong-term opioids therapy are assessed.
Pain Research and ManagementAttitudes Toward Opioid Use for Chronic Pain: A Canadian Physician Survey
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PubMedOpioids for chronic nonmalignant pain. Attitudes and practices of primary care physicians in the UCSF/Stanford Collaborative Research Network. University of California, San Francisco.
138 Citations2001Michael B. Potter, S Schafer +9 more
Primary care physicians are willing to prescribe schedule III opioids as needed, but many are unwilling to use schedule II opioids around the clock for patients with CNMP.
BMC Health Services ResearchA primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity
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Pain MedicineA Survey of Chronic Noncancer Pain Patients Prescribed Opioid Analgesics
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It is indicated that opioid therapy for CNCP does not necessarily lead to problematic drug use, and some problematic side effects are likely to be surmountable through appropriate prescribing.
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89 Citations2000Gloria M. Miele, Kenneth M. Carpenter +4 more
SDSS scores were significantly associated with time to first post treatment use of alcohol, cocaine and heroin, although the nature of the associations was complex.
PainWhat are the qualities of dilemmas experienced when prescribing opioids in general practice?
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Pain MedicineTrends in Medical Use and Abuse of Sustained-Release Opioid Analgesics: A Revisit
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PubMedPrinciples of opioid use in chronic noncancer pain.
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PubMedAre postal questionnaire surveys of reported activity valid? An exploration using general practitioner management of hypertension in older people.
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