Key Chapter Points:
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Clinicians must balance achieving pain relief and minimizing risk of drug abuse and diversion.
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Pain relievers are the third most commonly abused illicit drug category after marijuana and cocaine.
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Patient assessment, clinician decision-making, and discussions with the patient about pain treatment can be readily documented using standardized charting tools.
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Reasons for selecting specific therapy, treatment objectives, goal attainment, and consideration of therapy adjustment must be clearly documented in the patients' medical records.
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Reasons for using opioid therapy include failure of other pain therapy, inability to tolerate other medications, and severe, disabling pain.
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Continued opioid treatment must be contingent on treatment compliance and achievement of functional improvement goals, such as increased household chores, return to work, or increased ability to participate in physical or occupational therapy.
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Manchikanti L, Giordano J, Boswell MV, et al. Psychological factors as predictors of opioid abuse and illicit drug use in chronic pain patients. J Opioid Manag 2007;3:89–100
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Marcus, D.A. (2009). Risk Management in Chronic Pain Practice. In: Chronic Pain. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-60327-465-4_3
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DOI: https://doi.org/10.1007/978-1-60327-465-4_3
Publisher Name: Humana Press
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