Opioid Therapy in the 21st Century

Paperback | January 16, 2013

byHoward S. Smith

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Over the last thirty years, the concern of Pain Medicine practitioners about the potential for their patients to develop a dependence on opioids has left opioid therapy as a largely underutilized treatment. While there is no simple answer to chronic pain, opioids remain the only class of drugscapable of providing relief to patients experiencing serious pain. Opioid Therapy in the 21st Century, Second Edition fills a dearth of clinical knowledge about analgesics to aid practitioners in weighing the risks versus the benefits of opioid therapy for their chronic pain patients. Part of the Oxford American Pain Library, this concise guide serves as a practical, user-friendly reference for physicians across the range of primary care and medical specialties. It includes an overview of appropriate clinical applications of opioids, covering such topics as opioid pharmacology,route selection, and individualization of therapy, as well as strategies for managing and mitigating the risk of abuse, addiction, and diversion. There are also special sections dedicated to the unique needs of pediatric, geriatric, and palliative care patient populations. This second edition discusses opioids approved for use since publication of the first edition, such as Butrans (buprenorphine patch); fentanyl patch and nasal spray; abuse resistant version of Oxycontin; and Embeda (morphine sulfate). Approved indications for older opioids as well as clinical trialinformation have also been updated.

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From the Publisher

Over the last thirty years, the concern of Pain Medicine practitioners about the potential for their patients to develop a dependence on opioids has left opioid therapy as a largely underutilized treatment. While there is no simple answer to chronic pain, opioids remain the only class of drugscapable of providing relief to patients exp...

Howard S. Smith is Associate Professor of Anesthesiology and Physical Medicine and Rehabilitation Director of Pain Management in the Department of Anesthesiology at Albany Medical CollegeAlbany, New York

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Format:PaperbackDimensions:240 pages, 8 × 5 × 0.68 inPublished:January 16, 2013Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199844976

ISBN - 13:9780199844975

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Table of Contents

1. Introduction to Opioids2. Overview of Opioid-Related Terminology3. Diagnosis and Assessment of Pain4. Opioid Pharmacology5. Optimizing Pharmacologic Outcomes5a. Drug Selection5b. Route Selection5c. Assessing and Managing Opioid Side Effects5d. Opioid-Induced Hyperalgesia5e. Principles of Opioid Rotation5f. Individualization of Therapy6. Opioid Therapy for Cancer Pain7. Evidence for the Use of Long-Term Opioid Therapy in Persistent Noncancer Pain8. Pre-Opioid Prescribing Period9. Identifying Patients at Risk for Pain Medication Misuse10. Potential Documentation Tools in Long-Term Opioid Therapy11. Managing the Risk of Abuse, Addiction, and Diversion12. Special Populations12a. Pediatric12b. Geriatric12c. Palliative care13. Patients with a History of Substance Abuse14. ResourcesAppendix 1. Sample AAPM Consent for Chronic Opioid TherapyAppendix 2. Sample AAPM Agreement for Long-Term Controlled Substance Therapy for Chronic PainAppendix 3. Numerical Opioid Side Effect (NOSE) Assessment ToolAppendix 4. Translational Analgesia Score (TAS)Appendix 5. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain: Opioid Treatment Guidelines