Journal of opioid management
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Sleep problems are common among patients with chronic pain (CP). Information on sleep problems and associated covariates in opioid-treated patients with CP is limited. The aim of this study was to assess the prevalence, characteristics, and risk factors of sleep and daytime sleepiness problems in this specific population. ⋯ Sleep and daytime sleepiness problems are common among opioid-treated primary care patients with CP and seem to be related mainly to depression and pain severity. Physicians caring for opioid-treated patients with CP may want to assess them for sleep disorders as a part of routine CP care.
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Review
Comprehensibility and readability of patient self-administered opioid assessment screening tools.
The aims of this study were to evaluate the cognitive complexity and reading demands of patient self-administered Opioid Assessment Screening Tools (OASTs) for use in adults with nonmalignant pain. ⋯ Our study demonstrates that formatting characteristics, including linguistic problems, and high readability of several OAST statements or questions may hinder many patients' ability to accurately complete and comprehend OASTs independently.
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Opioids are commonly used in both cancer and noncancer pain. Many patients who require opioids have renal impairment. This can adversely influence the safety of opioids in these patients. ⋯ Consensus guidelines drawing on expertise from both palliative and renal physicians are needed to promote safer use of opioids in this vulnerable patient group.
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Multicenter Study Comparative Study
Use and misuse of buprenorphine in the management of opioid addiction.
Buprenorphine was approved in late 2004 for the treatment of opioid abuse and dependence in specially trained and certified physicians' offices. At the time of the approval, there was a regulatory concern that given the anticipated wide exposure there would be unexpectedly high levels of abuse in the high-risk population for which it was intended. To assess its abuse potential, the authors recruited more than 1000 individuals seeking treatment for prescription opioid abuse from 100 stand-alone (i.e., self-pay or insurance) drug abuse treatment programs around the country to determine whether they misused buprenorphine in the past 30 days to get high. ⋯ The most likely interpretation of these data is that the poly-substance-abusing population, for whom buprenorphine is intended, experimented with this medication for its mood-altering effects for a period of time, but presumably because of its lack of euphorogenic properties, its use has now dissipated. Additionally, support for this conclusion is the very rare endorsement of buprenorphine as a primary drug (<3 percent of the total sample). Thus, the results indicate that it is unlikely that buprenorphine abuse will ever reach the epidemic that was feared by some regulatory groups and that its use in opioid detoxification and maintenance should continue.
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To determine the proficiency in urine drug test interpretation among family medicine physicians who order these tests to monitor adherence in their patients on chronic opioid therapy. ⋯ Family medicine physicians who order urine drug testing to monitor their patients on chronic opioid therapy are not proficient in their interpretation. This study highlights the need for improved physician education in this area. It is imperative for physicians to work closely with certified laboratory professionals when ordering and interpreting urine drug tests.