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Cleve Clin J Med. 2016 Mar;83(3):207-15. doi: 10.3949/ccjm.83a.15034.

Prescribing opioids in primary care: Safely starting, monitoring, and stopping.

Author information

1
Assistant Professor, Yale University School of Medicine, Yale-New Haven Hospital, Saint Raphael's Campus, New Haven, CT, USA. E-mail: daniel.tobin@yale.edu.
2
Medical Director, Adult Primary Care Center, Yale-New Haven Hospital, New Haven, CT, USA.
3
Associate Professor of Medicine, University of Connecticut, Farmington, CT, USA.
4
Associate Program Director Categorical Internal Medicine, Director of Ambulatory Education, UConn Health, Farmington, CT, USA.
5
VA Connecticut Healthcare System, New Haven, CT, USA.
6
Assistant Professor, Yale University School of Medicine, New Haven, CT, USA.

Abstract

Chronic noncancer pain is common and often managed in the outpatient setting with chronic opioid therapy, even though the efficacy of this approach is uncertain and adverse effects are common. Some patients report meaningful benefit from opioids, but prescription drug abuse has reached epidemic proportions, and many suffer harm from opioid misuse, abuse, and diversion. Primary care providers and their care teams often struggle to balance these risks and benefits with little outside support. The authors review common challenges when starting, monitoring, and discontinuing opioids, and offer strategies for risk-reduction and patient communication.

Comment in

PMID:
26974992
DOI:
10.3949/ccjm.83a.15034
[Indexed for MEDLINE]
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