title: Current status and evolving role of abuse-deterrent opioids in managing patients with chronic pain.
abstract: Opioids are widely used for the treatment of patients with chronic pain; yet, the increase in their abuse, misuse, and diversion is an ongoing focus of regulatory, governmental, and legal scrutiny. As a consequence, clinicians are faced with numerous challenges in an effort to use opioids in appropriate patients with pain while minimizing the potential for opioid abuse, misuse, and diversion. Policies and programs such as state prescription monitoring programs, which have been in existence for decades, are but one attempt to address some of the issues regarding the prescribing of opioids. Another is a risk evaluation and mitigation strategy for opioids under consideration by the US Food and Drug Administration. At the clinical level, a universal precautions and risk management package that includes risk assessment and patient monitoring is a recommended approach. This approach can also include the use of abuse-deterrent and abuse-resistant formulations designed to reduce the nonmedical use of opioids. Several of these opioid formulations have been approved or should soon be on the market for use in the United States; however, their role and other questions regarding their use remain unanswered. The authors offer their clinical perspective on several of these key questions.
authors.affiliation: Lifetree Clinical Research and Pain Clinic, Salt Lake City, Utah, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Webster
authors.forename: Barbara
authors.initials: B
authors.lastname: St Marie
authors.forename: Bill
authors.initials: B
authors.lastname: McCarberg
authors.forename: Steven D
authors.initials: SD
authors.lastname: Passik
authors.forename: Sunil J
authors.initials: SJ
authors.lastname: Panchal
authors.forename: Eric
authors.initials: E
authors.lastname: Voth
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D002626:Chemistry, Pharmaceutical; D002908:Chronic Disease; D003692:Delayed-Action Preparations; D004345:Drug Industry; D016903:Drug Monitoring; D004335:Drug and Narcotic Control; D033161:Government Regulation; D006801:Humans; D009293:Opioid-Related Disorders / Q000517:prevention & control*; D010146:Pain / Q000188:drug therapy*; D010601:Pharmacology, Clinical; D012308:Risk Management; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations