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

Michael R. Clark, Steven A. Galati

Research output: Contribution to journalArticlepeer-review

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 1 2010

Keywords

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

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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