Opioid syndrome: failed opioid therapy for chronic noncancer pain.
Treatment of chronic noncancer pain (CNCP) with high-dose opioids (HDOs) has burgeoned over the past 2 decades in the United States. Characteristic domains and features of the failed CNCP management patient using long-term HDOs are described herein as the/an opioid syndrome (Schreiber AL, personal communication. 2013). Reversing or even modulating HDO use in patients with CNCP requires a paradigm shift on the part of physician, patient, and the societal "quick fix" medical culture. This review offers measures, agents, and strategies to consider in management of this pervasive, erosive medical and societal challenge.
MossRehab Outpatient Center, Albert Einstein Healthcare Network, 9880 Bustleton Avenue, Suite 309, Philadelphia, PA 19115, USA; Department of Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, PA, USA. Electronic address: lkamen@einstein.edu.
Leonard B
LB
Kamen
Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Kristofer J
KJ
Feeko
D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D010148:Intractable Pain / Q000175:diagnosis / Q000188:drug therapy*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D013577:Syndrome; D017211:Treatment Failure; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid
Buprenorphine; Chronic pain; Opioid dependence; Opioids; Pain management