By Peter S. Staats, Sanford M. Silverman
This complete advisor covers prescribing managed components for sufferers with acute or power discomfort and gives a balanced dialogue on acceptable remedy, habit, protection and issues. Chapters function evidence-based innovations and scientific modalities that handle diagnostic demanding situations, remedy tips, possible choices to opioid administration and the numerous criminal dangers in the present regulatory surroundings. Authored via leaders in ache medication, physicians and applicable well-being care execs will locate Controlled Substance administration in power discomfort to be an fundamental source.
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Additional info for Controlled Substance Management in Chronic Pain: A Balanced Approach
Regardless of the risk that patients might possess for aberrant behaviors, patients on chronic opioid therapy should periodically undergo urine drug testing to conﬁrm that the patients remain adherent to their prescribed treatment . Opioid Risk Stratiﬁcation It is essential that proper assessments be completed to take reasonable steps to guard against abuse and diversion and to ensure that patients will be treated safely and effectively. A chronic pain assessment should include a detailed assessment of the pain itself, including intensity, quality, location, and radiation of pain.
In addition, as extended-release hydromorphone was approved by the FDA, the ﬁnal separation between placebo and active drug from a 12-week study was less than one point. Methadone The unique pharmacokinetics and molecular properties of methadone allow it to be both very effective as an analgesic in treating chronic pain but also potentially dangerous if abused or inappropriately prescribed. Once regarded as a common treatment for opioid addiction maintenance because of its extremely long 5-day half-life, the use of methadone in the treatment of chronic pain as increased but has been followed by a disproportionately large spike in overdose deaths .
A randomized, open-label, multicenter trial comparing once-a-day Avinza (morphine sulfate extended-release capsules) versus twice-a-day OxyContin (oxycodone hydrochloride controlled release tablets) for the treatment of chronic, moderate to severe low back pain; improved physical function in the ACTION trial. J Opioid Manage. 2007;3:35–43. 16. Adams E, et al. A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. J Pain Symptom Manage. 2006;31:465–76.
Controlled Substance Management in Chronic Pain: A Balanced Approach by Peter S. Staats, Sanford M. Silverman