title: "Nonmedical" prescription opioid use in North America: a call for priority action.
abstract: Nearly four years after the United States Congress heralded a "decade of pain control and research", chronic pain remains a mounting public health concern worldwide. The escalating prevalence of chronic pain in recent years has been paralleled by a rise in prescription opioid availability, misuse, and associated human and social costs. However, national monitoring surveys in the U.S. and Canada currently fail to differentiate between prescription opioid misuse for the purposes of euphoria versus pain or withdrawal management. Furthermore, there is a lack of evidence-based guidelines for pain management among high-risk individuals, and a glaring lack of education for practitioners in the areas of pain and addiction medicine. Herein we propose multiple avenues for intervention and research in order to mitigate the individual, social and structural problems related to undertreated pain and prescription opioid misuse.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6 Vancouver, BC, Canada. uhri-tk@cfenet.ubc.ca.
authors.forename: Pauline
authors.initials: P
authors.lastname: Voon
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D006801:Humans; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000592:standards; D017410:Practice Guidelines as Topic; D012651:Self Medication; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid