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JAAPA. 2015 May;28(5):23-7. doi: 10.1097/

The evolution of chronic opioid therapy and recognizing addiction.

Author information

Akiva M. Daum is an addiction psychiatry fellow at Boston (Mass.) University School of Medicine. Oren Berkowitz is director of research and an assistant professor in the PA program at Boston University School of Medicine. John A. Renner Jr. is a professor of psychiatry and director of the addiction fellowship program at Boston University School of Medicine, and associate chief of psychiatry for the Veterans Affairs Boston Healthcare System. Dr. Renner discloses that he is a paid speaker for the American Psychiatric Association and American Academy of Addiction Psychiatry, and holds stock in Johnson & Johnson. The authors have disclosed no other potential conflicts of interest, financial or otherwise.


Chronic pain is one of the most common complaints in the United States. Opioids have become a frequently prescribed treatment for patients with chronic nonmalignant pain. Concurrently, opioid use disorders have risen to epidemic levels. Studies investigating iatrogenic opioid addiction have been of limited quality. Aberrant drug-related behaviors may be warning signs of impending addiction. Proper screening and close monitoring are essential for managing patients on opioids for chronic nonmalignant pain.

[Indexed for MEDLINE]

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