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Scope of the Problem: Intersection of Chronic Pain and Addiction

Abstract

The use of prescription opioids in the management of chronic pain has drastically changed over the past two decades. This chapter focuses on several key concepts including terminology, risks of prescribing opioids, clinicians who prescribe opioids, and tools to help clinicians who treat pain patients become more aware of the principles of addiction medicine.

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References

  1. Jamison R, Serraillier J, Michna E. Assessment and treatment of abuse risk in opioid prescribing for chronic pain. Pain Res Treat. 2011;2011:1–12.

    Article  Google Scholar 

  2. Schneider J, Kirsh K. Defining clinical issues around tolerance, hyperalgesia, and addiction: a quantitative and qualitative outcome study of long-term opioid dosing in a chronic pain practice. J Opioid Manage. 2010;6(6):385–95.

    Article  Google Scholar 

  3. Passik S, Miller N, Ruehle M, Kirsh K. Substance abuse in oncology. In: Grassi L, Riba M, editors. Psychopharmacology in oncology and palliative care. 1st ed. Springer: Berlin; 2014. p. 267–93.

    Google Scholar 

  4. Passik S, Kirsh K. Assessing aberrant drug-taking behaviors in the patient with chronic pain. Curr Pain Headache Rep. 2004;8(4):289–94.

    Article  PubMed  Google Scholar 

  5. Ballantyne J, Sullivan M, Kolodny A. Opioid dependence vs addiction. Arch Intern Med. 2012;172(17):1342.

    Article  PubMed  Google Scholar 

  6. American Society of Addiction Medicine (ASAM) Definitions related to the use of opioids for the treatment of pain. 2001. Available from: http://www.asam.org/docs/publicy-policy-statements/1opioid-definitions-consensus-2-011.pdf?sfvrsn=0 (cited 26 Feb 2015).

  7. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Publishing; 2000.

    Google Scholar 

  8. Lee M, Silverman S, Hansen H, Patel V, Manchikanti L. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14:145–61.

    PubMed  Google Scholar 

  9. Ruscheweyh R, Sandkuhler J. Opioids and central sensitisation: II. Induction and reversal of hyperalgesia. Eur J Pain. 2005;9(2):149–52.

    Article  CAS  PubMed  Google Scholar 

  10. Silverman S. Opioid induced hyperalgesia: clinical implications for the pain practitioner. Pain Physician. 2009;12:679–84.

    PubMed  Google Scholar 

  11. Fishbain D, Cole B, Lewis J, Gao J, Rosomoff R. Do opioids induce hyperalgesia in humans? An evidence-based structured review. Pain Med. 2009;10(5):829–39.

    Article  PubMed  Google Scholar 

  12. Angst M, Clark J. Opioid-induced hyperalgesia: a qualitative systematic review. Acute Pain. 2006;8(4):191.

    Article  Google Scholar 

  13. Jones C, Bruehl S, Passik S. Androgen ablation is associated with increased pain sensitivity and lowered pain threshold in men with prostate cancer. In preparation.

    Google Scholar 

  14. Basaria S, Travison T, Alford D, Knapp P, Teeter K, Cahalan C, et al. Effects of testosterone replacement in men with opioid-induced androgen deficiency. Pain. 2015;156(2):280–8.

    Article  CAS  PubMed  Google Scholar 

  15. Kwon J, Tanco K, Hui D, Reddy A, Bruera E. Chemical coping versus pseudoaddiction in patients with cancer pain. Pall Supp Care. 2014;12(05):413–7.

    Article  Google Scholar 

  16. Passik S, Kirsh K. Chemical coping: the clinical middle ground. In: Smith H, Passik S, editors. Pain and chemical dependency. 1st ed. New York: Oxford University Press; 2008. p. 299–302.

    Google Scholar 

  17. Kirsh K, Peppin J, Coleman J. Characterization of prescription opioid abuse in the United States: focus on route of administration. J Pain Palliat Care Pharmacother. 2012;26(4):348–61.

    Article  PubMed  Google Scholar 

  18. Substance Abuse and Mental Health Services Administration. The NSDUH Report: Substance Use and Mental Health Estimates from the 2013 National Survey on Drug Use and Health: Overview of Findings. Rockville, MD: SAMHSA Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality; 2014.

    Google Scholar 

  19. Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings. Rockville, MD: NSDUH Series H-49, HHS Publication No. (SMA) 14-4887; 2014.

    Google Scholar 

  20. Sjogren P, Ekholm O, Peuckmann V, Gronbaek M. Epidemiology of chronic pain in Denmark: an update. Eur J Pain. 2009;13(3):287–92.

    Article  PubMed  Google Scholar 

  21. Manchikanti L, Singh A. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician. 2008;11(2S):S63–88.

    PubMed  Google Scholar 

  22. Morasco B, Dobscha S. Prescription medication misuse and substance use disorder in VA primary care patients with chronic pain. Gen Hosp Psychiatry. 2008;30(2):93–9.

    Article  PubMed  Google Scholar 

  23. Cicero T, Surratt H, Kurtz S, Ellis M, Inciardi J. Patterns of prescription opioid abuse and comorbidity in an aging treatment population. J Subst Abuse Treat. 2012;42(1):87–94.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Johnson H, Paulozzi L, Porucznik C, Mack K, Herter B. Centers for Disease Control and Prevention. Decline in drug overdose deaths after state policy changes—Florida, 2010–2012. Morb Mortal Wkly Rep (MMWR). 2014;63(26):569–74.

    Google Scholar 

  25. State of New Jersey Commission of Investigation. Scenes from an epidemic: a report on the SCI’s investigation of prescription pill and heroin abuse. NJ: Trenton; 2013.

    Google Scholar 

  26. Cole B. Recognizing and preventing medication diversion. Fam Pract Manage. 2001;8(9):37–41.

    CAS  Google Scholar 

  27. Cdc.gov. CDC—Facts—Drug Overdose—Home and Recreational Safety—Injury Center [Internet]. 2015. Available from: http://www.cdc.gov/homeandrecreationalsafety/overdose/facts.html (cited 24 Feb 2015).

  28. Jones J, Mogali S, Comer S. Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug Alcohol Depend. 2012;125(1–2):8–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Gudin J, Mogali S, Jones J, Comer S. Risks, management, and monitoring of combination opioid, benzodiazepines, and/or alcohol use. Postgrad Med. 2013;125(4):115–30.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Coambs R, Jarry J. The SISAP: a new screening instrument for identifying potential opioid abusers in the management of chronic nonmalignant pain within general medical practice. Pain Res Manage. 1996;1(3):155–62.

    Article  Google Scholar 

  31. Butler S, Budman S, Fernandez K, Jamison R. Validation of a screener and opioid assessment measure for patients with chronic pain. Pain. 2004;112(1):65–75.

    Article  CAS  PubMed  Google Scholar 

  32. Passik S, Kirsh K, Whitcomb L, Portenoy R, Katz N, Kleinman L, Dodd S, Schein J. A new tool to assess and document pain outcomes in chronic pain patients receiving opioid therapy. Clin Ther. 2004;26(4):552–61.

    Article  CAS  PubMed  Google Scholar 

  33. Smith H, Kirsh K. Documentation and potential tools in long-term opioid therapy for pain. Anesthesiol Clin. 2007;25(4):809–23.

    Article  PubMed  Google Scholar 

  34. Webster L, Webster R. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the opioid risk tool. Pain Med. 2005;6(6):432–42.

    Article  PubMed  Google Scholar 

  35. Webster L. the role of urine drug testing in chronic pain management: 2013 update. Pain Med News. 2013;11:45–50.

    Google Scholar 

  36. Nafziger A, Bertino J. Utility and application of urine drug testing in chronic pain management with opioids. Clin J Pain. 2009;25(1):73–9.

    Article  PubMed  Google Scholar 

  37. Lum G, Mushlin B. Urine drug testing: approaches to screening and confirmation testing. Lab Med. 2004;35(6):368–73.

    Article  Google Scholar 

  38. Haga S, LaPointe N. The potential impact of pharmacogenetic testing on medication adherence. Pharmacogenomics J. 2013;13(6):481–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Tennant F. Cytochrome P450 testing in high-dose opioid patients. Practical Pain Management [Internet]. 2012;12(7). Available from: http://www.practicalpainmanagement.com/treatments/pharmacological/opioids/cytochrome-p450-testing-high-dose-opioid-patients (cited 24 Feb 2015).

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Correspondence to Steven D. Passik .

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Trigeiro, A.A., Kirsh, K.L., Passik, S.D. (2016). Scope of the Problem: Intersection of Chronic Pain and Addiction. In: Staats, P., Silverman, S. (eds) Controlled Substance Management in Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-30964-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-30964-4_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30962-0

  • Online ISBN: 978-3-319-30964-4

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