opioid dependence; chronic opioid use

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Etiology

Epidemiology

  • the U.S. represents < 5% of the world's population, yet it consumes ~80% of the world's opioid supply[2]
  • 1/3 of long-term opiate users report dependence[4]

Clinical manifestations

Complications

Differential diagnosis

  • differs from opioid abuse (which includes a component of opiate use for effects other than relief of pain)

Management

Notes

More general terms

Additional terms

References

  1. Jump up to: 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 19. American College of Physicians, Philadelphia 2006, 2012, 2021.
  2. Jump up to: 2.0 2.1 Express Scripts Drug Safety and Abuse Dec 9, 2014 http://lab.express-scripts.com/insights/drug-safety-and-abuse/americas-pain-points
  3. Jump up to: 3.0 3.1 D'Onofrio G et al Emergency Department-Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence. A Randomized Clinical Trial. JAMA. 2015;313(16):1636-1644 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25919527
    Physician's First Watch, Dec 12, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  4. Jump up to: 4.0 4.1 4.2 Orciari Herman A, Sadoughi S, Sofair A. 1 in 3 Long-Term Rx Opioid Users Report Dependence Physician's First Watch, Dec 12, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  5. Jump up to: 5.0 5.1 Sullivan M, Bisaga A, Pavlicova M et al. Long-acting injectable naltrexone induction: A randomized trial of outpatient opioid detoxification with naltrexone versus buprenorphine. Am J Psychiatry 2017 Jan 10; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28068780 <Internet> http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.16050548
  6. Jump up to: 6.0 6.1 Tanum L, Solli KK, Latif Z et al The Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid DependenceA Randomized Clinical Noninferiority Trial. JAMA Psychiatry. Published online October 18, 2017. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29049469 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2657484
  7. Jump up to: 7.0 7.1 FDA News Release. Nov 15, 2017 FDA grants marketing authorization of the first device for use in helping to reduce the symptoms of opioid withdrawal. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm585271.htm
  8. Jump up to: 8.0 8.1 Darnall BD, Ziadni MS, Stieg RL, Mackey IG, Kao MC, Flood P. Patient-centered prescription opioid tapering in community outpatients with chronic pain. JAMA Intern Med 2018 Feb 19 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29459978 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2672574
  9. Jump up to: 9.0 9.1 Donohue JM, Kennedy JN, Seymour CW et al. Patterns of opioid administration among opioid-naive inpatients and associations with postdischarge opioid use: A cohort study. Ann Intern Med 2019 Jun 18; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31207646 https://annals.org/aim/article-abstract/2736099/patterns-opioid-administration-among-opioid-naive-inpatients-associations-postdischarge-opioid?doi=10.7326%2fM18-2864
    Larochelle MR, Bohnert ASB. Opportunities to address first opioid prescriptions to reduce incident long-term opioid use. Ann Intern Med 2019 Jun 18 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31207647 https://annals.org/aim/article-abstract/2736100/opportunities-address-first-opioid-prescriptions-reduce-incident-long-term-opioid
  10. Jump up to: 10.0 10.1 10.2 HHS News Release. Oct 10, 2019 HHS Announces Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use. https://www.hhs.gov/about/news/2019/10/10/hhs-announces-guide-appropriate-tapering-or-discontinuation-long-term-opioid-use.html
  11. Jump up to: 11.0 11.1 Garland EL et al. Mind-body therapies for opioid-treated pain: A systematic review and meta-analysis. JAMA Intern Med 2019 Nov 4; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31682676 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2753680
  12. Jump up to: 12.0 12.1 Oliva EM et al. Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: Observational evaluation. BMJ 2020 Mar 4; 368:m283. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32131996 Free Article https://www.bmj.com/content/368/bmj.m283