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Opioid Management
Opioids: narcotic drugs that are generally prescribed to manage pain. Narcotic is a legal, not a medical term or classification. The most commonly prescribed opioids are: buprenorphine, butorphanol, codeine, fentanyl, hydrocodone, hydromorphone, levorphanol, meperidine, methadone, morphine, nalbuphine, oxycodone, oxymorphone, pentazocine, and propoxyphene. These opioids are prescribed alone or in combination with aspirin or acetaminophen.
Expert pain management physicians are greatly needed for the administration and management of opioid pain medicine. Why? It is because most doctors are uncomfortable with, or refuse to write, prescriptions for these drugs (except for terminal cancer pain), for several reasons, some of which are listed below:
- The perceived and real legal ramifications of prescribing controlled substances
- Known adverse-effects of opioid therapy
- The need for increasing doses related to tolerance to therapy
- The potential for addiction and abuse of opioids
- The inability to predict when an opioid will be effective
- Incomplete relief when chronic opioids are used to treat non-cancer pain
- Lack of belief in patient subjective reports of pain
- Complexity of having to write monthly prescriptions for controlled substances
- Difficulty dealing with co-morbidities in the chronic pain population
Also Opioid management entails many considerations and complex
assessment algorithms which include topics such as:
- Assessment of Pain
- Diagnosis
- Alternatives to opioids
- How opioids interact with other medications
- Screen for Sensitivity or Allergy to Specific Opioids
- Documentation and the DEA
- Tapering someone off opioids
- Hazards of long time opioid use
- Medico-legal risk management
- Routes of Administration of Opioids
- Opioid Titration
- Use of Long Acting Opioids
- Addictions and doctor shopping
- Types and uses of opioids
- Dosing levels by types of pain
- Rotation of opioids
- Opioid Withdrawal
- Opioid toxicology and drug testing
Now it is easy to see why opioid management is often referred to the
careful expertise of pain specialists such as Dr Julie Chen at
Advanced
Pain
Management
Center in
Westerville,
Ohio.
More info on this subject can be found at:
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