Expert Decision Making on Opioid Treatment

Paperback | March 21, 2013

EditorJane Ballantyne, David J. Tauben

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Opioid treatment for chronic pain has been popularized over the past few decades, and opioid usage has increased several-fold. Opioid treatment of chronic pain increased for several reasons: a sense that chronic pain had previously been undertreated; strong underwriting of medical education bydrug companies anxious to sell new "designer" opioids; lifting of the stigma associated opioids, particularly as pain advocacy reestablished opioids as necessary and appropriate treatment for acute and cancer pain. What has emerged is that there are several limitations to chronic opioid treatment.What has become clear in this unfortunate history is that non-specialists were persuaded to prescribe opioids before they could possibly understand the complexity of the treatment. So great were the pressures to prescribe, from drug companies, advocates, and many well-meaning people who saw opioidsas the panacea for suffering, opioids were prescribed indiscriminately. It became almost impossible to deny opioids without seeming inhumane. What we learned though, is that while carefully selected and managed opioid therapy can benefit certain patients, casual use fails in several respects. What is needed then is a vast educational effort to help clinicians understand some of the complexities of opioid therapy, and in particular, how toselect patients, and subsequently manage and monitor so as to achieve continued efficacy without losing control of pain and drug use. While no one educational effort can solve the whole problem, this book aims to provide clinicians with expert opinion on how to manage certain common scenariosinvolving opioid management of chronic pain. It will provide the reader not only with an easy reference to the management of common clinical scenarios where opioids are involved, but also with in depth analysis of the difficult issues surrounding a treatment that is both uniquely effective andpotentially harmful.

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Opioid treatment for chronic pain has been popularized over the past few decades, and opioid usage has increased several-fold. Opioid treatment of chronic pain increased for several reasons: a sense that chronic pain had previously been undertreated; strong underwriting of medical education bydrug companies anxious to sell new "designe...

Jane Ballantyne is Professor of Education and Research in the Department of Anesthesiology and Pain Medicine at the University of Washington School of Medicine, Seattle, Washington, USA. David J. Tauben is Clinical Associate Professor in the Department of Anesthesia and Pain Medicine at the University of Washington School of Medicine, ...

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Format:PaperbackDimensions:240 pages, 8.25 × 5.5 × 0.68 inPublished:March 21, 2013Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199768889

ISBN - 13:9780199768882

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Table of Contents

1. Catherine F. Stannard: Pain without a Pathoanatomic Diagnosis2. Seddon R. Savage and Julie Franklin Sorensen: Opioid Therapy of Chronic Pain in Persons with known Substance Use Disorder3. Robert N. Jamison, Edward Michna, and Juliana Serraillier: Screening before Embarking: How to Screen for Addiction Risk in Opioid Prescribing4. Functional Pain Syndromes5. Stephen C. Brown, Lisa Isaac, Patricia A. McGrath, and Jennifer Tyrrell: Chronic Opioid Therapy in Childhood and Adolescence6. Eija Kalso: Debilitating Pain7. Shane Brogan and Perry G. Fine: Chronic Cancer Pain8. William C. Becker and Robert D. Kerns: Pain After Trauma (including PTSD)9. Daniel Krashin and Andrea M. Trescot: Opioid Therapy in Chronic Painful Disease10. James P. Robinson: United States Workers Compensation and Disability11. David Tauben: Using Measurement-based Tools to Improve Pain Care12. Jane Ballantyne: Not a Suitable Candidate: Saying No