title: Current State of Opioid Therapy and Abuse.
abstract: Currently, there is growing tension between the twin challenges of opioid therapy for chronic pain and adverse consequences of abuse, leading to multiple complications including respiratory failure and death. The recent data from Centers for Disease Control and Prevention (CDC) have shown continued escalation of prescription opioid use with opioid overdose deaths topping all previous estimations. Numerous policy initiatives, advisories, and guidelines have been advanced through the years to control the opioid epidemic. The strategies to prevent opioid abuse and to maintain opioid therapy when medically necessary fall into primary and secondary prevention categories. The primary prevention category is extremely crucial, since it involves education of primary care providers and patients at the starting point of opioid therapy. The education of surgeons and other prescribers is as crucial as the education of primary care physicians.
authors.affiliation: Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, Kentucky, 42003, USA. drlm@thepainmd.com.|Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA. drlm@thepainmd.com.
authors.forename: Laxmaiah
authors.initials: L
authors.lastname: Manchikanti
authors.affiliation: Department of Pharmacy Practice, University of Pacific, Thomas J. Long School of Pharmacy and Health Sciences, 3601 Pacific Avenue, Stockton, CA, 95211, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Kaye
authors.affiliation: Department of Anesthesia, LSU Health Science Center, 1542 Tulane Ave Room 659, New Orleans, LA, 70112, USA.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Kaye
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D002649:Child Abuse / Q000517:prevention & control; D059350:Chronic Pain / Q000188:drug therapy*; D062787:Drug Overdose / Q000188:drug therapy*; D006801:Humans; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid
keywords: Abuse resistance opioids; Chronic opioid therapy; Opioid abuse; Opioid adverse consequences; Opioid deaths; Opioid overdoses; Prescription drug monitoring programs (PDMPs)