Opioid Pharmacotherapy for Chronic Noncancer Pain: The American Experience
The Korean Journal of Pain
;
: 3-13, 2013.
Artigo
em Inglês
| WPRIM
| ID: wpr-40596
ABSTRACT
Chronic noncancer pain is a significant and growing public health challenge in the United States. Lacking effective alternative interventions for effective chronic noncancer pain management, many physicians have turned to opioid pharmacotherapy. Increased opioid prescribing brings not only gains in therapeutic benefit but also a higher incidence of adverse drug events including increased medication misuse and opioid related mortality. Currently the United States must confront the dual problems of widespread undertreated chronic noncancer pain and a prescription opioid abuse crisis. Withholding pain relieving drugs from patients in need is unjustifiable, yet drug diversion, abuse and adverse drug events have become major social as well as medical problems. At the heart of this crisis is the lack of definitive evidence about the risk to benefit ratio of opioid pharmacotherapy for chronic noncancer pain both on an individual case and on a population basis. This article describes the extent and severity of the American chronic noncancer pain problem and the history of opioid pharmacotherapy for chronic noncancer pain in the United States. It then discusses the concept of evidence based practice and reviews current evidence supporting opioid pharmacotherapy for chronic noncancer pain as well as adverse drug events related to opioid pharmacotherapy including misuse and abuse. Finally, it considers the conflict of providing pain relief versus protecting society and reviews steps that governmental agencies, industry and others are taking to contain and ultimately resolve the problems of excessive prescribing and conflicting priorities.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Estados Unidos
/
Saúde Pública
/
Incidência
/
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
/
Prática Clínica Baseada em Evidências
/
Prescrições
/
Dor Crônica
/
Manejo da Dor
/
Coração
Tipo de estudo:
Estudo de incidência
/
Estudo prognóstico
Limite:
Humanos
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
The Korean Journal of Pain
Ano de publicação:
2013
Tipo de documento:
Artigo
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