title: Exploring the Use of Chronic Opioid Therapy for Chronic Pain: When, How, and for Whom?
abstract: This article provides a broad overview regarding intent to initiate and consider ongoing chronic opioid therapy (COT) for treatment of chronic noncancer pain (CNCP). COT should be an individualized decision based on a comprehensive evaluation, assessment, and monitoring. It is imperative that providers discuss various risks and benefits of COT initially and at follow-up visits, and continue appropriate monitoring and follow-up at regular intervals. The decision to initiate or continue opioid therapy is based on clinical judgment; however, it is understood that opioid and other medication therapy represent one piece of the complete treatment plan for patients with CNCP.
authors.affiliation: Pain Management, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Brooks
authors.affiliation: Pain Management, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Kominek
authors.affiliation: Pain & Palliative Care, Stratton VA Medical Center, Albany, NY, USA.
authors.forename: Thien C
authors.initials: TC
authors.lastname: Pham
authors.affiliation: Pain Management, PGY2 Pain & Palliative Care Pharmacy Residency, Stratton VA Medical Center, Albany, NY, USA; Western New England University College of Pharmacy, Springfield, MA, USA; Albany College of Pharmacy & Health Sciences, Albany, NY, USA; University of Connecticut School of Pharmacy, Storrs, CT, USA. Electronic address: jeff@paindr.com.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fudin
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D006801:Humans; D010147:Pain Measurement / Q000379:methods; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid
keywords: Chronic noncancer pain; Chronic opioid therapy; Opioid induced respiratory depression; Opioid risk management; Pain management