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Pain Med. 2009 Jul;10 Suppl 2:S101-14. doi: 10.1111/j.1526-4637.2009.00670.x.

Current risk assessment and management paradigms: snapshots in the life of the pain specialist.

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  • 1Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.


Opioid analgesics can be a safe and effective treatment option for patients with chronic pain, but issues surrounding their use-including side effects, tolerance, and the potential for misuse and diversion-prompt some clinicians to avoid using these agents, and can lead to the continued undertreatment of pain. This article offers practical advice to clinicians who choose to prescribe opioid analgesics. Through a series of case presentations, it illustrates the steps health care providers can take to prepare their practice for opioid prescribing, assess and select patients for opioid treatment, initiate and manage therapy, and address concerns about aberrant behaviors.

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