title: Opioid abuse-deterrent strategies: role of clinicians in acute pain management.
abstract: Opioid abuse is a healthcare and societal problem that burdens individuals, their families and the healthcare professionals who care for them. Restricting access to opioid analgesics is one option to deter abuse, but this may prevent pain patients in need from obtaining effective analgesics. Therefore, strategies that mitigate the risk of opioid abuse while maintaining access are being pursued by several stakeholders including federal agencies, state governments, payors, researchers, the pharmaceutical industry and clinicians. Federal agency efforts have included required licensure and documentation for prescribing opioids, implementation of risk evaluation and mitigation strategies, and guidance on assessment and labeling of opioid abuse-deterrent formulations. In addition, state governments and payors have enacted monitoring programs, and pharmaceutical companies continue to develop abuse-deterrent opioid formulations. Strategies for clinicians to mitigate opioid abuse include comprehensive patient assessment and universal precautions (e.g. use of multimodal analgesia and abuse-deterrent opioid formulations, urine toxicology screening, participation in prescription drug monitoring and risk evaluation and mitigation strategy programs).
authors.affiliation: a Scientific Affairs , PRA International , Salt Lake City , UT , USA.
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Webster
authors.affiliation: b The Pain Center of Fairfield , Fairfield , CT , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Brennan
authors.affiliation: c Department of Orthopedic Surgery , Harbor-UCLA Medical Center , Torrance , CA , USA.
authors.forename: Louis M
authors.initials: LM
authors.lastname: Kwong
authors.affiliation: d RUTGERS - Robert Wood Johnson Medical School , New Brunswick , NJ , USA.|e RUTGERS - New Jersey Medical School , Newark , NJ , USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Levandowski
authors.affiliation: f Pain Management and Palliative Care , Englewood Hospital and Medical Center , Englewood , NJ , USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Gudin
mesh_terms: D059787:Acute Pain / Q000188:drug therapy*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016903:Drug Monitoring; D004335:Drug and Narcotic Control; D019983:Guideline Adherence; D006801:Humans; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D060735:Pharmacovigilance; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D014481:United States
chemical_list: D000701:Analgesics, Opioid
keywords: Acute pain; Analgesics; Opioid; Opioid-related disorders; Pain; Pain management; Postoperative