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The evolution of chronic opioid therapy and recognizing addiction
Akiva M Daum1, Oren Berkowitz, John A Renner
1Akiva M. Daum is an addiction psychiatry fellow at Boston (Mass.) University School of Medicine. Oren Berkowitz is director of research and an assistant professor in the PA program at Boston University School of Medicine. John A. Renner Jr. is a professor of psychiatry and director of the addiction fellowship program at Boston University School of Medicine, and associate chief of psychiatry for the Veterans Affairs Boston Healthcare System. Dr. Renner discloses that he is a paid speaker for the American Psychiatric Association and American Academy of Addiction Psychiatry, and holds stock in Johnson & Johnson. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
Chronic pain management with opioids requires careful monitoring. Aberrant drug behaviors can signal addiction, necessitating early screening and close patient observation to prevent opioid use disorders.
Area of Science:
- Pain Management
- Addiction Medicine
- Pharmacology
Background:
- Chronic pain affects a significant portion of the US population.
- Opioids are commonly prescribed for chronic nonmalignant pain.
- Rising rates of opioid use disorders present a public health crisis.
Purpose of the Study:
- To review the quality of studies on iatrogenic opioid addiction.
- To highlight the importance of identifying warning signs for opioid addiction.
- To emphasize the need for effective screening and monitoring protocols.
Main Methods:
- Literature review of studies on opioid addiction.
- Analysis of aberrant drug-related behaviors as indicators.
- Discussion of clinical management strategies.
Main Results:
- Existing research on iatrogenic opioid addiction quality is limited.
- Aberrant drug-related behaviors are potential predictors of addiction.
- Screening and monitoring are crucial for patient safety.
Conclusions:
- Effective management of chronic pain with opioids necessitates vigilant patient assessment.
- Early identification of at-risk patients through screening is vital.
- Close monitoring can mitigate the development of opioid use disorders.
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