Addiction to prescription opioids: characteristics of the emerging epidemic and treatment with buprenorphine.
Dependence on and abuse of prescription opioid drugs is now a major health problem, with initiation of prescription opioid abuse exceeding cocaine in young people. Coincident with the emergence of abuse and dependence on prescription opioids, there has been an increased emphasis on the treatment of pain. Pain is now the "5th vital sign" and physicians face disciplinary action for failure to adequately relieve pain. Thus, physicians are whipsawed between the imperative to treat pain with opioids and the fear of producing addiction in some patients. In this article, the authors characterize the emerging epidemic of prescription opioid abuse, discuss the utility of buprenorphine in the treatment of addiction to prescription opioids, and present illustrative case histories of successful treatment with buprenorphine.
California Pacific Medical Center Research Institute, St. Luke's Hospital, and Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94110, USA. john.mendelson@cpmcri.org
John
J
Mendelson
Keith
K
Flower
Mark J
MJ
Pletcher
Gantt P
GP
Galloway
D000701:Analgesics, Opioid; D002047:Buprenorphine / Q000627:therapeutic use*; D004196:Disease Outbreaks; D006801:Humans; D008297:Male; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D010146:Pain / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D055553:Prescription Drugs; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D055553:Prescription Drugs; D002047:Buprenorphine