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Erschienen in: Current Pain and Headache Reports 11/2017

01.11.2017 | Migraine and Beyond (R Cowan, Section Editor)

Treatment Strategies for the Opioid-Dependent Patient

verfasst von: Shweta Teckchandani, Meredith Barad

Erschienen in: Current Pain and Headache Reports | Ausgabe 11/2017

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Abstract

Purpose of Review

This review is intended to help the headache physician think through and plan for management issues concerning the use of opioids. We ask the headache physician to consider if there are instances where prescribing or continuing prescriptions of opiates is plausible, and if so, how can the physician proceed as safely as possible. Our goal is to start a conversation regarding the inevitable encounter with a patient on opiates or requesting opiates.

Recent Findings

The use of opiates in our society has reached a crisis in staggering death and addiction rates. Recent guideline published by the CDC can assist us in developing an algorithmic approach towards opiate use. Recent advances in addiction medicine can also assist us in protecting our patients.

Summary

Every headache physician will undoubtedly encounter patients on opiates. There still are appropriate reasons to treat patients with opiates. Every headache physician may need to prescribe opiates and they may be indicated. It is important to learn the correct way to approach, manage, and treat patients on opiates.
Literatur
1.
Zurück zum Zitat Paulozzi LJ, Mack KA, Hockenberry JM, Division of Unintentional Injury Prevention NCfIP, Control CDC. Vital signs: variation among states in prescribing of opioid pain relievers and benzodiazepines—United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(26):563–8.PubMedPubMedCentral Paulozzi LJ, Mack KA, Hockenberry JM, Division of Unintentional Injury Prevention NCfIP, Control CDC. Vital signs: variation among states in prescribing of opioid pain relievers and benzodiazepines—United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(26):563–8.PubMedPubMedCentral
2.
Zurück zum Zitat • Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016;65(5051):1445–52. 10.15585/mmwr.mm655051e1. The most recent statistics on opiate deaths published by the CDC.CrossRefPubMed • Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016;65(5051):1445–52. 10.​15585/​mmwr.​mm655051e1. The most recent statistics on opiate deaths published by the CDC.CrossRefPubMed
3.
Zurück zum Zitat Warner M, Trinidad JP, Bastian BA, Minino AM, Hedegaard H. Drugs most frequently involved in drug overdose deaths: United States, 2010–2014. Natl Vital Stat Rep. 2016;65(10):1–15. Warner M, Trinidad JP, Bastian BA, Minino AM, Hedegaard H. Drugs most frequently involved in drug overdose deaths: United States, 2010–2014. Natl Vital Stat Rep. 2016;65(10):1–15.
4.
Zurück zum Zitat • Katz J. Drug deaths in America are rising faster than ever. New York Times. 2017 June 5, 2017. The New York Times has partnered with the CDC to predict drug overdose deaths for 2016. • Katz J. Drug deaths in America are rising faster than ever. New York Times. 2017 June 5, 2017. The New York Times has partnered with the CDC to predict drug overdose deaths for 2016.
7.
Zurück zum Zitat Perez-Pena R. Ohio sues drug makers, Saying They Aided Opioid Epidemic New York Times. 2017 31, 2017. Perez-Pena R. Ohio sues drug makers, Saying They Aided Opioid Epidemic New York Times. 2017 31, 2017.
11.
Zurück zum Zitat Choong CK, Ford JH, Nyhuis AW, Joshi SG, Robinson RL, Aurora SK, et al. Clinical characteristics and treatment patterns among patients diagnosed with cluster headache in U.S. healthcare claims data. Headache. 2017; https://doi.org/10.1111/head.13127. Choong CK, Ford JH, Nyhuis AW, Joshi SG, Robinson RL, Aurora SK, et al. Clinical characteristics and treatment patterns among patients diagnosed with cluster headache in U.S. healthcare claims data. Headache. 2017; https://​doi.​org/​10.​1111/​head.​13127.
13.
Zurück zum Zitat •• Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016. 65(RR-1):1–49. 10.15585/mmwr.rr6501e1. Another version of the above paper published by the CDC. •• Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016. 65(RR-1):1–49. 10.​15585/​mmwr.​rr6501e1. Another version of the above paper published by the CDC.
14.
Zurück zum Zitat Larry Durstine JL, Gordon B, Wang Z, Luo X. Chronic disease and the link to physical activity. J Sport Health Sci. 2013;2(1):3–11.CrossRef Larry Durstine JL, Gordon B, Wang Z, Luo X. Chronic disease and the link to physical activity. J Sport Health Sci. 2013;2(1):3–11.CrossRef
19.
Zurück zum Zitat Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl Health Stat Report. 2015(79):1–16. Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl Health Stat Report. 2015(79):1–16.
21.
Zurück zum Zitat • Cook KF, Jensen SE, Schalet BD, Beaumont JL, Amtmann D, Czajkowski S, et al. PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. J Clin Epidemiol. 2016;73:89–102. https://doi.org/10.1016/j.jclinepi.2015.08.038. An examination of the validity of the NIH’s Patient Reported Outcome Measurement Information Systems across different populations.CrossRefPubMedPubMedCentral • Cook KF, Jensen SE, Schalet BD, Beaumont JL, Amtmann D, Czajkowski S, et al. PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. J Clin Epidemiol. 2016;73:89–102. https://​doi.​org/​10.​1016/​j.​jclinepi.​2015.​08.​038. An examination of the validity of the NIH’s Patient Reported Outcome Measurement Information Systems across different populations.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162(4):276–86. https://doi.org/10.7326/M14-2559.CrossRefPubMed Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162(4):276–86. https://​doi.​org/​10.​7326/​M14-2559.CrossRefPubMed
25.
Zurück zum Zitat • Lembke A, Humphreys K, Newmark J, et al. Am Fam Physician. 2016;93(12):982–90. Excellent review outlining approaches to managing opioids and screening for abuse.PubMed • Lembke A, Humphreys K, Newmark J, et al. Am Fam Physician. 2016;93(12):982–90. Excellent review outlining approaches to managing opioids and screening for abuse.PubMed
31.
Zurück zum Zitat Brennen MJ, Fudin J, Perkins RJ. Opioid calculator. Practical Pain Management. 2017. Accessed 29 June 2017. Brennen MJ, Fudin J, Perkins RJ. Opioid calculator. Practical Pain Management. 2017. Accessed 29 June 2017.
35.
Zurück zum Zitat HHS. Key substance use and mental health indicators in the United States: results from the 2015 National Survey on Drug Use and Health. In: Quality CfBHSa, editor. HHS Publication No. SMA 16–4984, NSDUH Series H-512016. https://www.samhsa.gov/data/ HHS. Key substance use and mental health indicators in the United States: results from the 2015 National Survey on Drug Use and Health. In: Quality CfBHSa, editor. HHS Publication No. SMA 16–4984, NSDUH Series H-512016. https://​www.​samhsa.​gov/​data/​
36.
Zurück zum Zitat Association AP. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.CrossRef Association AP. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.CrossRef
38.
Zurück zum Zitat • Yarborough BJ, Stumbo SP, Janoff SL, Yarborough MT, McCarty D, Chilcoat HD, et al. Understanding opioid overdose characteristics involving prescription and illicit opioids: a mixed methods analysis. Drug Alcohol Depend. 2016;167:49–56. https://doi.org/10.1016/j.drugalcdep.2016.07.024. This study looks more deeply at the phenotype of opiate abusers, by investigating the context of their abuse and their life circumstances.CrossRefPubMed • Yarborough BJ, Stumbo SP, Janoff SL, Yarborough MT, McCarty D, Chilcoat HD, et al. Understanding opioid overdose characteristics involving prescription and illicit opioids: a mixed methods analysis. Drug Alcohol Depend. 2016;167:49–56. https://​doi.​org/​10.​1016/​j.​drugalcdep.​2016.​07.​024. This study looks more deeply at the phenotype of opiate abusers, by investigating the context of their abuse and their life circumstances.CrossRefPubMed
42.
Zurück zum Zitat • Nunes EV, Gordon M, Friedmann PD, Fishman MJ, Lee JD, Chen DT, et al. Relapse to opioid use disorder after inpatient treatment: protective effect of injection naltrexone. J Subst Abus Treat. 2017; https://doi.org/10.1016/j.jsat.2017.04.016. This medication may be a breakthrough in the treatment of opioid abuse, stay tuned. • Nunes EV, Gordon M, Friedmann PD, Fishman MJ, Lee JD, Chen DT, et al. Relapse to opioid use disorder after inpatient treatment: protective effect of injection naltrexone. J Subst Abus Treat. 2017; https://​doi.​org/​10.​1016/​j.​jsat.​2017.​04.​016. This medication may be a breakthrough in the treatment of opioid abuse, stay tuned.
47.
Zurück zum Zitat • Kornfeld H. Buprenorphine: everything you need to know. California Healthcare Foundation. 2016:1–11. A very practical paper for how to prescribe and use buprenorphine. • Kornfeld H. Buprenorphine: everything you need to know. California Healthcare Foundation. 2016:1–11. A very practical paper for how to prescribe and use buprenorphine.
49.
Metadaten
Titel
Treatment Strategies for the Opioid-Dependent Patient
verfasst von
Shweta Teckchandani
Meredith Barad
Publikationsdatum
01.11.2017
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 11/2017
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-017-0644-6

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