Chronic Noncancer Pain Rehabilitation With Opioid Withdrawal: Comparison of Treatment Outcomes Based on Opioid Use Status at Admission

2004 ◽  
Vol 79 (6) ◽  
pp. 759-768 ◽  
Author(s):  
Jeffrey D. Rome ◽  
Cynthia O. Townsend ◽  
Barbara K. Bruce ◽  
Christopher D. Sletten ◽  
Connie A. Luedtke ◽  
...  
2004 ◽  
Vol 79 (6) ◽  
pp. 759-768 ◽  
Author(s):  
Jeffrey D. Rome ◽  
Cynthia O. Townsend ◽  
Barbara K. Bruce ◽  
Christopher D. Sletten ◽  
Connie A. Luedtke ◽  
...  

2010 ◽  
Vol 23 (5) ◽  
pp. 598-601 ◽  
Author(s):  
Christoph Stein ◽  
Henriette Reinecke ◽  
Hardo Sorgatz

2010 ◽  
Vol 58 (7) ◽  
pp. 1353-1369 ◽  
Author(s):  
Maria Papaleontiou ◽  
Charles R. Henderson Jr ◽  
Barbara J. Turner ◽  
Alison A. Moore ◽  
Yelena Olkhovskaya ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Élise Roy ◽  
Richard J. Côté ◽  
Denis Hamel ◽  
Pierre-André Dubé ◽  
Éric Langlois ◽  
...  

Aim. To examine medical practices and training needs of Québec family physicians with respect to pain management and opioid prescription for chronic noncancer pain (CNCP). Methodology. An online survey was carried out in 2016. Results. Of 636 respondents (43.0% men; 54.3% ≥ 50 years old), 15.2% and 70.9% felt very or somewhat confident that they could properly prescribe opioids for CNCP. Concerns related to abuse (72.5% strongly/somewhat agree), dependence (73.2%), and lack of support (75.4%) were the main barriers reported. Only 19.7% always/often screened their patients for risks of abuse and dependence using a screening tool. About two-thirds of participants (65.7%) had recently (last five years) taken part in continuing education programs on opioid use for CNCP and 73.4% on CNCP management. Patient evaluation and differential diagnoses of chronic pain syndromes were rated as a top priority for further training. Conclusions. This study provides insights into Québec family physicians’ concerns, practices, and needs with respect to the management of CNCP. Physicians’ difficulties around the application of strategies to mitigate the problem of opioid abuse and addiction are worrying. The need to better train physicians in the field of pain and addiction cannot be emphasized enough.


2015 ◽  
Vol 20 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Erica A Brooks ◽  
Anita Unruh ◽  
Mary E Lynch

BACKGROUND: Chronic noncancer pain (CNCP) and prescription opioid use is a highly complex and growing health care issue in Canada. Many quantitative research studies have investigated the effectiveness of opioids for chronic pain; however, gaps remain in the literature regarding the personal experience of using opioids and their impact on those experiencing CNCP.OBJECTIVE: To explore the lived experience of adults using prescription opioids to manage CNCP, focusing on how opioid medication affected their daily lives.METHODS: In-depth qualitative interviews were conducted with nine adults between 40 and 68 years of age who were using prescription opioids daily for CNCP. Interviews were audiorecorded and transcribed, and subsequently analyzed using interpretive phenomenological analysis.RESULTS: Six major themes identified positive and negative aspects of opioid use associated with social, physical, emotional and psychological dimensions of pain management. These themes included the process of decision making, and physical and psychosocial consequences of using opioids including pharmacological side effects, feeling stigmatized, guilt, fears, ambivalence, self-protection and acceptance.CONCLUSION: Although there were many negative aspects to using opioids daily, the positive effects outweighed the negative for most participants and most of the negative aspects were socioculturally induced rather than caused by the drug itself. The present study highlighted the complexities involved in using prescription opioids daily for management of CNCP for individuals living with pain.


2020 ◽  
Vol 23 (1) ◽  
pp. 123-134
Author(s):  
Launette M. Rieb ◽  
Zainab Samaan ◽  
Andrea D. Furlan ◽  
Kiran Rabheru ◽  
Sid Feldman ◽  
...  

BackgroundIn Canada, rates of hospital admission from opioid overdose are higher for older adults (≥ 65) than younger adults, and opioid use disorder (OUD) is a growing concern. In response, Health Canada commissioned the Canadian Coalition of Seniors’ Mental Health to create guidelines for the prevention, screening, assessment, and treatment of OUD in older adults.MethodsA systematic review of English language literature from 2008–2018 regarding OUD in adults was conducted. Previously published guidelines were evaluated using AGREE II, and key guidelines updated using ADAPTE method, by drawing on current literature. Recommendations were created and assessed using the GRADE method.ResultsThirty-two recommendations were created. Prevention recommendations: it is key to prioritize non-pharmacological and non-opioid strategies to treat acute and chronic noncancer pain. Assessment recommendations: a comprehensive assessment is important to help discern contributions of other medical conditions. Treatment recommendations: buprenorphine is first line for both withdrawal management and maintenance therapy, while methadone, slow-release oral morphine, or naltrexone can be used as alternatives under certain circumstances; non-pharmacological treatments should be offered as an integrated part of care.ConclusionThese guidelines provide practical and timely clinical recommendations on the prevention, assessment, and treatment of OUD in older adults within the Canadian context.


2021 ◽  
Vol 4 (4) ◽  
pp. e213059
Author(s):  
Louisa Degenhardt ◽  
Phillip Hungerford ◽  
Suzanne Nielsen ◽  
Raimondo Bruno ◽  
Briony Larance ◽  
...  

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