Introduction: landscape of opioid dependence.
BACKGROUND
The use of opioids for chronic noncancer pain increased 222% from 1992 to 2002. Opioid dependence has also increased significantly, leading to a burden on patients, employers, insurers, society, and the entire health care system. It is imperative that opioid dependence is addressed and treated properly, in order to return patients to being productive participants in the workplace and society.


OBJECTIVE
To provide an overview of addiction, abuse, and dependence and identify risk factors for addiction.


CONCLUSIONS
Studies have shown that intensive use of opioids is associated with increased utilization of costly health care services, prolonged disability, and continued use of opioids, leading to abuse and dependence in many patients. While identifying patients at risk for developing opioid dependence is difficult, there are many risk stratification tools now available to practitioners, including the Opioid Risk Tool (ORT) or Screener and Opioid Assessment for Patients with Pain (SOAPP). Understanding the differences between dependence, addiction, and tolerance is essential to managing patients on opioids.


CONCLUSIONS
It is imperative that patients be properly managed when being treated for pain. Physicians and employers have to be able to identify patients at risk for opioid abuse or exhibiting symptoms of opioid abuse and know how to address their needs.
Horizon Blue Cross Blue Shield of New Jersey, Newark, NJ 07105-2200, USA. Saira_Jan@horizon-bcbsnj.com.
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D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000191:economics; D002908:Chronic Disease; D017281:Cost of Illness; D004185:Disability Evaluation; D017048:Health Care Costs; D006801:Humans; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000191:economics / Q000209:etiology* / Q000628:therapy; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics; D010147:Pain Measurement; D018570:Risk Assessment; D012307:Risk Factors; D009626:Terminology as Topic
D000701:Analgesics, Opioid