Journal of opioid management
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Comparative Study
Preliminary data on a new opioid risk assessment measure: the Brief Risk Interview.
Risk assessment and stratification have become a central issue in prescribing opioids to patients with chronic pain. Research to date on various risk screening measures has shown that a clinical interview by an experienced clinician offers superior predictive ability in identifying patients who are more likely to engage in future medication aberrant behavior. The current study represents a pilot study of an interview rating scale that is designed to replicate this clinical assessment. ⋯ A sample of 196 patients was assessed by each of the three risk measures and then follow-up data were gathered at 6 months post interview to determine which patients had engaged in medication aberrant behavior and had been discharged from the practice. The BRI shows superior predictive ability in identifying patients who later engage in medication aberrant behavior. Although more study in other settings is needed, these preliminary data suggest that the Brief Risk Interview could be a useful tool for any pain clinician in assessing risk through the use of information gathered in a brief interview.
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To answer a question whether or not rapid methadone dose increase can be associated with onset of hypoglycemia. This hypothesis is based on the previously reported case reports of hypoglycemia with rapid methadone increase and our clinical experience of a number of cases when symptomatic hypoglycemia during rapid methadone escalation was initially mistaken for methadone overdose. ⋯ Present report is the first reported series of patients with hypoglycemic episodes associated with rapid methadone dose escalation. Based on our results, a patient who develops unexplained sweating, palpitations, or lethargy during methadone titration may benefit from blood glucose monitoring.