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Improving opioid prescription practices and reducing patient risk in the primary care setting

Authors Cheatle M, Barker C

Received 21 January 2014

Accepted for publication 9 April 2014

Published 10 June 2014 Volume 2014:7 Pages 301—311


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Martin D Cheatle, Cody Barker

Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

Abstract: Chronic pain is complex, and the patient suffering from chronic pain frequently experiences concomitant medical and psychiatric disorders, including mood and anxiety disorders, and in some cases substance use disorders. Ideally these patients would be referred to an interdisciplinary pain program staffed by pain medicine, behavioral health, and addiction specialists. In practice, the majority of patients with chronic pain are managed in the primary care setting. The primary care clinician typically has limited time, training, or access to resources to effectively and efficiently evaluate, treat, and monitor these patients, particularly when there is the added potential liability of prescribing opioids. This paper reviews the role of opioids in managing chronic noncancer pain, including efficacy and risk for misuse, abuse, and addiction, and discusses several models employing novel technologies and health delivery systems for risk assessment, intervention, and monitoring of patients receiving opioids in a primary care setting.

Keywords: chronic pain, opioids, addiction

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