The opioid renewal clinic: A primary care, managed approach to opioid therapy in chronic pain patients at risk for substance abuse

Pain Medicine

Volumn 8, Issue 7, 2007, Pages 573-584

  Wiedemer, Nancy L ^a   Harden, Paul S ^a   Arndt, Isabelle O ^a   Gallagher, Rollin M ^a,b  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Chronic noncancer pain; Opioids; Pain medicine; Pharmacy costs; Primary care; Substance abuse

Indexed keywords

OPIATE; OXYCODONE;

CHRONIC PAIN; CLINICAL PHARMACY; DRUG COST; DRUG DEPENDENCE TREATMENT; DRUG DOSE TITRATION; HEALTH PROGRAM; HUMAN; MAJOR CLINICAL STUDY; MANAGED CARE; NURSE PRACTITIONER; OPIATE ADDICTION; OUTCOME ASSESSMENT; PATIENT ATTITUDE; PATIENT COMPLIANCE; PATIENT REFERRAL; PATIENT SATISFACTION; PHARMACIST; PRACTICE GUIDELINE; PRESCRIPTION; PRIMARY HEALTH CARE; PROSPECTIVE STUDY; REVIEW; RISK ASSESSMENT; SUBSTANCE ABUSE; URBAN AREA; URINALYSIS;

ADULT; ANALGESICS, OPIOID; CHRONIC DISEASE; DELIVERY OF HEALTH CARE, INTEGRATED; FEMALE; HUMANS; MALE; OPIOID-RELATED DISORDERS; OUTCOME ASSESSMENT (HEALTH CARE); PAIN; PAIN CLINICS; PHILADELPHIA; PREVALENCE; PRIMARY HEALTH CARE; PROGRAM EVALUATION; RISK ASSESSMENT; RISK FACTORS; TREATMENT OUTCOME;

EID: 34548767412     PISSN: 15262375     EISSN: 15264637     Source Type: Journal    
DOI: 10.1111/j.1526-4637.2006.00254.x     Document Type: Review

References (59)

1. Gallagher RM. Biopsychosocial pain medicine and mind-brain-body science. Phys Med Rehabil 2004; 15: 855-82.
2. Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA. The epidemiology of chronic pain in the community. Lancet 1999; 354: 1248-52.
3. Reid MC, Engles-Horton LL, Weber MB, et al. Use of opioid medications for chronic noncancer pain syndromes in primary care. J Gen Intern Med 2002; 17: 173-9.
4. Clark JD. Chronic pain prevalence and analgesic prescribing in a general medical population. J Pain Symptom Manage 2002; 23: 131-7.
5. McCaffery M, Pasero C. Pain: Clinical Manual. St. Louis, MO: Mosby; 1999: 23-31.
6. Rome HP, Rome JD. Limbically augmented pain syndrome; kindling, corticolimbic sensitization, and the convergence of affective and sensory symptoms in chronic pain disorders. Pain Med 2000; 1: 7-23.
7. Mendell JR, Sahenk Z. Painful sensory neuropathy. NEJM 2003; 348: 1243-55.
8. Woolf CJ. Pain: Moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med 2004; 140: 441-51.
9. Vallerand AH. The use of long-acting opioids in chronic pain management. Nurs Clin North Am 2003; 38: 435-45.
10. Fishbain DA, Rosomoff HL, Rosomoff RS. Drug abuse, dependence, and addiction in chronic pain patients. Clin J Pain 1992; 8: 77-85.
11. Gallagher RM. Pain medicine and primary care: A community solution to pain as a public health problem. Med Clin North Am 1999; 83: 555-85.
12. Gallagher RM. The pain medicine and primary care community rehabilitation model: Monitored care for pain disorders in multiple settings. Clin J Pain 1999; 15: 1-3.
13. Cutler R, Fishbain DA, Rosomoff HL, et al. Does nonsurgical pain center treatment of chronic pain return patients to work? A review and meta-analysis of the literature. Spine 1994; 19: 643-52.
14. Fishbain DA, Cutler B, Rosomoff H, Steele-Rosomoff R. Pain facilities: A review of their effectiveness and referral selection criteria. Curr Rev Pain 1997; 1: 107-15.
15. Turk DC. Efficacy of multidisciplinary pain centers in the treatment of chronic pain. Prog Pain Res Manag 1996; 7: 257-74.
16. Savage SR. Opioid use in the management of chronic pain. Med Clin North Am 1999; 83: 761-85.
17. American Geriatric Society. The management of chronic pain in older persons. JAGS 1998; 46: 635-51.
18. Tramer MR, Moore RA, Reynolds DJ, McQuay HJ. Quantatative estimation of rare adverse events which follow a biological progression: A new model applied to chronic NSAID use. Pain 2000; 85: 169-82.
19. Solomon DH, Schneeweiss S, Glynn RJ, et al. Relationship between selective cyclooxygenase-2 inhibitors and acute myocardial infarction in older adults. Circulation 2004; 109: 2068-73.
20. Nussmeier NA, Whelton AA, Brown MT, et al. Complications of the cox-2 inhibitors parecoxib and valdecoxib after cardiac surgery. NEJM 2005; 352: 1081-91.
21. Portenoy RK. Current pharmacotherapy of chronic pain. J Pain Symptom Manage 2000; 19: S16-25.
22. Ballantyne JC, Mao J. Opioid therapy for chronic pain. NEJM 2003; 349: 1943-53.
23. Jamison RN, Raymond SA, Slawsby EA, Nedeljkovic SS, Katz NP. Opioid therapy for chronic noncancer back pain: A randomized controlled study. Spine 1998; 23: 2591-600.
24. Rowbotham MC, Twilling L, Davis PS, et al. Oral opioid therapy for chronic peripheral and central neuropathic pain. NEJM 2003; 348: 1223-32.
25. Roth S, Fleischman RM, Burch FX, et al. Around-the-clock, controlled-release oxycodone therapy for osteoarthritis-related pain. Arch Intern Med 2000; 160: 853-60.
26. American Academy of Pain Medicine and the American Pain Society. The Use of Opioids for the Treatment of Chronic Pain: A Consensus Document. Glenview, IL: American Academy of Pain Medicine and the American Pain Society; 1997. Available at: http://www.painmed.org (accessed October 9, 2005).
27. The American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. Definitions Related to the Use of Opioids for the Treatment of Pain: A Consensus Document. Glenview, IL: The American Academy of Pain Medicine; 2001. Available at: http://www.painmed.org (accessed October 9, 2005).
28. Federation of State Medical Boards of the United States, Inc. Model Guidelines for the Use of Controlled Substances for the Treatment of Pain. A Policy Document, May 1998.
29. Adams NJ, Plane MB, Fleming MF, et al. Opioids and the treatment of chronic pain in a primary care sample. J Pain Symptom Manage 2001; 22: 791-6.
30. Olsen Y, Daumit GL. Chronic pain and narcotics. J Intern Med 2002; 17: 238-40.
31. Savage SR, Joranson DE, Covington EC, et al. Definitions related to the medical use of opioids: Evolution towards universal agreement. J Pain Symptom Manage 2003; 26: 655-67.
32. Chelminski PR, Ives TJ, Felix KM, et al. A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity. BMC Health Serv Res 2005; 5: 1-13.
33. Fishman SM. From balanced pain care to drug trafficking: The case of Dr. William Hurwitz and the DEA. Pain Med 2005; 6(2): 162-4.
34. Hurwitz W. The challenge of prescription drug misuse: A review and commentary. Pain Med 2005; 6(2): 152-61.
35. Passik SD, Kirsh KL. Opioid therapy in patients with a history of substance abuse. CNS Drugs 2004; 18: 13-25.
36. Compton P, Darakjian J, Miotto K. Screening for addiction in patients with chronic pain and "problematic" substance use: Evaluation of a pilot assessment tool. J Pain Symptom Manage 1998; 16: 355-63.
37. Fishman S, Gallagher RM, Carr D, Sullivan L. The case for pain medicine as a medical specialty. Pain Med 2004; 5(3): 281-6.
38. Gallagher RM, Rauh V, Haugh L, et al. Determinants of return to work in low back pain. Pain 1989; 39(1): 55-68.
39. Jamison RN, Ginter L, Rogers JF, Fairchild DG. Disease management for chronic pain: Barriers of program implementation with primary care physicians. Pain Med 2002; 3(2): 92-101.
40. Wiedemer N, Harden P, Arndt R, Gallagher R. Effects of a structured opioid therapy program, using treatment agreements, urine drug screens, and consultation, on primary care practice. Pain Med 2005; 6(2): 191-2.
41. Joint Commission on Accreditation of Healthcare. Hospital Accreditation Standards, 2001.
42. Veterans health Administration, Geriatrics and extended care strategic healthcare group, National Pain Management Coordinating Committee. Pain as the 5th Vital Sign Toolkit. Washington, DC: 810 Vermont Avenue NW; 2000.
43. Chabal C, Erjavec MK, Jacobson L, Mariano A, Chaney E. Prescription opiate abuse in chronic pain patients: Clinical criteria, incidence, and predictors. Clin J Pain 1997; 13: 150-5.
44. Katz N, Fanciullo GJ. Role of urine toxicology testing in the management of chronic opioid therapy. Clin J Pain 2002; 18: S76-82.
45. Heit HA, Gourlay DL. Urine drug testing in pain medicine. J Pain Sypmtom Manage 2004; 27: 260-7.
46. Gourlay DL, Heitt HA, Almahrezi A. Universal precautions in pain medicine: A rational approach to the treatment of chronic pain. Pain Med 2005; 6(2): 107-12.
47. Fishman SM, Wilsey B, Yang J, et al. Adherence monitoring and drug surveillance in chronic opioid therapy. J Pain Symptom Manage 2000; 20: 293-307.
48. Compton P, Athanasos P. Chronic pain, substance abuse and addiction. Nurs Clin North Am 2003; 38: 525-37.
49. Weissman DE, Haddox JD. Opioid pseudoaddiction: An iatrogenic syndrome. Pain 1989; 36: 363-6.
50. Portenoy RK. Opioid therapy for nonmalignant pain: A review of the critical issues. J Pain Symptom Manage 1996; 11: 203-17.
51. Nedeljkovic SS, Wasan A, Jamison RN. Assessment of efficacy of long-term opioid therapy with substance abuse potential. Clin J Pain 2002; 18: S39-51.
52. Passik SD, Weinreb HJ. Managing chronic nonmalignant pain: Overcoming obstacles to the use of opioids. Adv Ther 2000; 17: 70-83.
53. Brendt S, Maier C, Schutz HW. Polymedication and medication compliance in patients with chronic non-malignant pain. Pain 1993; 52: 331-9.
54. The national survey on drug use and health (NSDUH). SAMHSA; 2003. Available at: http://www.samsha.gov/oas/2k3/NSDUH/nsduh.pdf (accessed August 12, 2005).
55. Primm BJ, Perez L, Dennis GC, et al. Managing pain: The challenge of the underserved populations: Appropriate use versus abuse and diversion. J Natl Med Assoc 2004; 96: 1152-61.
56. Woolfe CJ, Hashmi M. Use and abuse of opioid analgesics: Potential methods to prevent and deter non-medical consumption of prescription opioids. Curr Opin Investig Drugs 2004; 5: 61-6.
57. Regier DA, Farmer ME, Rae DS, et al. Comorbidity of mental disorders with alcohol and other drugs of abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511-8.
58. Doherty D. "The addiction medicine/pain medicine interface." Presented at the American Society of Pain Management Nurses 12th Annual Meeting, March 1-4, 2002, in Salt Lake City, Utah.
59. Harden RN. Chronic opioid therapy: Another reappraisal. Am Pain Soc Bull 2002; 12.