Opioids and psychological issues: A practical, patient-centered approach to a risk evaluation and mitigation strategy

Michael Clark, Steven A. Galati

Research output: Contribution to journalArticle

Abstract

The use of long-term opioid therapy for the management of chronic pain remains controversial. The highlighted consequences of long-term opioid therapy are aberrant drug-taking behaviors, abuse, and dependence. However, the limitations of this treatment modality usually can be attributed to a lack of efficacy and adverse events. Patients that remain refractory to long-term opioid therapy for chronic pain often have a psychiatric disorder that is acting as a barrier to effectiveness. While standardized approaches to the evaluation of a patient to receive long-term opioid therapy are established, little data exists to document their ability to limit opioid abuse or enhance their efficacy. Screening questionnaires and other attempts at predicting or detecting opioid-related substance use disorders fail to determine the presence of comorbid psychiatric disorders. A comprehensive approach for the psychiatric evaluation of patients with chronic pain will address specific barriers to successful chronic pain management and optimize the chances for success with long-term opioid therapy.

Original languageEnglish (US)
Pages (from-to)261-267
Number of pages7
JournalEuropean Journal of Pain Supplements
Volume4
Issue number4
DOIs
StatePublished - Nov 2010

Fingerprint

Opioid Analgesics
Psychology
Chronic Pain
Psychiatry
Therapeutics
Aptitude
Pain Management
Substance-Related Disorders
Drug Therapy

Keywords

  • Chronic pain
  • Opioids
  • Patient-centered
  • Psychiatry
  • Substance abuse
  • Treatment

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Opioids and psychological issues : A practical, patient-centered approach to a risk evaluation and mitigation strategy. / Clark, Michael; Galati, Steven A.

In: European Journal of Pain Supplements, Vol. 4, No. 4, 11.2010, p. 261-267.

Research output: Contribution to journalArticle

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