@article{469614ba7d21418e80a9f1ce6f590a1e,
title = "Identification and management of pain medication abuse and misuse: Current state and future directions",
abstract = "Long-term opioid therapy poses a risk for abuse and misuse in some patients. Identifying which patients may potentially be at risk prior to initiation of therapy, and identifying patients in whom these problems develop during therapy, are significant challenges. Outcome prediction is impeded by the complexity of the problem, where considerable heterogeneity results from psychological and socioeconomic factors, as well as interindividual variation in biological pathways due to genetic and epigenetic factors. Screening tools designed to detect opioid misuse and urine drug testing are both used clinically; scant evidence currently exists to allow the formulation of an algorithm for judicious use of these tools. Moreover, these tools may not be addressing the underlying alterations in biological pathways that occur owing to the development of chronic pain or in response to chronic opioid administration. An evidence-based algorithmic approach to risk mitigation that can be applied in a cost-effective manner to guide therapy is urgently needed.",
keywords = "opioid abuse, opioid misuse, outcome prediction, pain medication questionnaire, screening tools, urine drug testing",
author = "Hartrick, {Craig T.} and Gatchel, {Robert J.} and Sean Conroy",
note = "Funding Information: Elisa Manzotti, Publisher, Future Science Group, London, UK Disclosure: Elisa Manzotti has disclosed no relevant financial relationships. CME Author Laurie Barclay, MD, Freelance writer and reviewer, Medscape, LLC Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships. Authors Craig T Hartrick, MD, FIPP, Biomedical Sciences (Pharmacology), Oakland University William Beaumont School of Medicine, Rochester, MI, USA Disclosure: Craig T Hartrick, MD, FIPP, recently participated in Webinars for Indian physicians sponsored by Glenmark and Wolters Kluwer and has received research grant funding from Ortho-McNeil in the past. Robert J Gatchel, PhD, ABPP, Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, TX, USA Disclosure: Robert J Gatchel, PhD, ABPP, has disclosed no relevant financial relationships. Sean Conroy, MD, FIPP, Pain Division, Department of Anesthesiology, Beaumont Health System, Troy, MI, USA Disclosure: Sean Conroy, MD, FIPP, has disclosed no relevant financial relationships.",
year = "2012",
month = may,
doi = "10.1586/ern.12.34",
language = "English",
volume = "12",
pages = "601--610",
journal = "Expert Review of Neurotherapeutics",
issn = "1473-7175",
publisher = "Taylor and Francis Ltd.",
number = "5",
}