RT Book, Section A1 Jamison, Robert N. A1 Ross, Edgar L. A2 Bajwa, Zahid H. A2 Wootton, R. Joshua A2 Warfield, Carol A. SR Print(0) ID 1131931810 T1 Evaluation for Opioid Management in Chronic Pain T2 Principles and Practice of Pain Medicine, 3e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071766838 LK neurology.mhmedical.com/content.aspx?aid=1131931810 RD 2024/03/28 AB Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic pain, and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. This is a brief review of opioid abuse and misuse issues that often arise in the treatment of patients with chronic noncancer pain and an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic pain have significant medical, psychiatric, and substance use comorbidities that affect treatment decisions, and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Medical practitioners should regularly use urine drug screens to monitor adherence to long-term opioid therapy. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, a discussion is presented of the future of abuse-deterrent opioids and other potential strategies for pain management.