Misuse Of Opioid Analgesics Research Articles

The Use of Risk-Management Approaches to Protect Patients With Cancer-Related Pain and Their Healthcare Providers

To describe the factors that contribute to the risk for undertreatment of cancer pain, as well as the risk factors associated with misuse or abuse of opioid analgesics, and to describe approaches to identify and manage the risks. Published research, articles from a literature review, and U. S. statistics. Oncology nurses should perform systematic assessments to determine whether patients are at risk for undertreatment of cancer pain or whether they are at risk for abuse or addiction to opioid analgesics. Oncology nurses must develop effective approaches to manage both types of risk. Patient education is a critical component to help patients who are at risk for undertreatment to adhere to analgesic regimens and to experience optimal benefit from medications. For patients who are at risk for abuse or addiction, oncology nurses should perform ongoing screening for behaviors that are predictive of addiction and implement appropriate interventions to reduce risks of abuse. Oncology clinicians should have a balanced perspective of risk management within the context of cancer pain management. Clinicians must be cognizant of the fact that a significant risk exists for undertreatment of cancer pain. In addition, oncology nurses should recognize patients who are at risk for abuse or addiction or who are actively abusing opioid analgesics and establish appropriate safeguards for patients with cancer and oncology clinicians.

Quantifying morbidity associated with the abuse and misuse of opioid analgesics: A comparison of two approaches

Background. Due to the rising nonmedical use of opioid analgesics, methods are needed to quantify the associated health-related consequences. Methods. Using opioid analgesic intentional exposure reports from poison control centers from January 2003–June 2004, we calculated quarterly rates for 7 opioids at the 3-digit ZIP code level using population- and patient-based denominators. Results. Hydrocodone was the most widely prescribed opioid (maximum: 5,321,390 patients per quarter), with the largest intentional exposure caseload (range: 498–1,290), and the highest aggregate population-based rate (maximum of 13.61 cases per 1,000,000 individuals). Methadone had the highest aggregate patient-based rate (maximum 2.03 cases per 1,000 patients). Conclusion. Population- and patient-based rates are complementary tools that address different public health questions. Population-based rates describe the health-related burden of nonmedical opioid analgesic use on the community as a whole, while patient-based rates show this burden (“risk”) in relation to the level of corresponding medicinal use (“benefit”) within a given area.