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Expert Decision Making on Opioid Treatment (Paperback)
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Expert Decision Making on Opioid Treatment (Paperback)
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Opioid treatment for chronic pain has been popularized over the
past few decades, and opioid usage has increased several-fold.
Opioid treatment of chronic pain increased for several reasons: a
sense that chronic pain had previously been undertreated; strong
underwriting of medical education by drug companies anxious to sell
new "designer" opioids; lifting of the stigma associated opioids,
particularly as pain advocacy reestablished opioids as necessary
and appropriate treatment for acute and cancer pain. What has
emerged is that there are several limitations to chronic opioid
treatment. What has become clear in this unfortunate history is
that non-specialists were persuaded to prescribe opioids before
they could possibly understand the complexity of the treatment. So
great were the pressures to prescribe, from drug companies,
advocates, and many well-meaning people who saw opioids as the
panacea for suffering, opioids were prescribed indiscriminately. It
became almost impossible to deny opioids without seeming inhumane.
What we learned though, is that while carefully selected and
managed opioid therapy can benefit certain patients, casual use
fails in several respects. What is needed then is a vast
educational effort to help clinicians understand some of the
complexities of opioid therapy, and in particular, how to select
patients, and subsequently manage and monitor so as to achieve
continued efficacy without losing control of pain and drug use.
While no one educational effort can solve the whole problem, this
book aims to provide clinicians with expert opinion on how to
manage certain common scenarios involving opioid management of
chronic pain. It will provide the reader not only with an easy
reference to the management of common clinical scenarios where
opioids are involved, but also with in depth analysis of the
difficult issues surrounding a treatment that is both uniquely
effective and potentially harmful.
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