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Chronic opioid therapy issues associated with opioid abuse potential
Journal of Opioid Management, 11/03/09

Smith HS et al. – Chronic opioid therapy continues to be an important “mainstream” option for the relief of pain, despite continued debate over the efficacy and safety of utilizing opioids with chronic noncancer populations. With this increase in utilization for medical purposes, the authors have also experienced a troubling rise in the abuse and diversion of prescription opioids. Providers should note this relationship and always perform due diligence when assessing whether a patient with chronic noncancer pain is an appropriate candidate for opioid therapy based on potential risk factors. To this end, a set of guidelines are discussed to promote an approach to chronic noncancer pain utilizing “universal precautions” principles. In addition, several risk tools are evaluated, including the Screener and Opioid Assessment for Patients with Pain–Revised (SOAPP–R), the Opioid Risk Tool (ORT), and the Pain Assessment and Documentation Tool (PADT). Finally, discussion is presented regarding what practices seen in opioid prescribing can be considered “in–or–out” of the mainstream box.