Paradigm Shift in Chronic Pain

Steven D. Passik, PhD

Among clinicians who treat patients with acute and chronic pain, the paradigm for prescribing opioids now explicitly addresses the risks associated with opioid medications, the importance of risk stratification for all patients, and of structuring opioid therapy consistent with the predefined and evolving level of risk.

References

Passik SD, Kirsh KL. The interface between pain and drug abuse and the evolution of strategies to optimize pain management while minimizing drug abuse. Exp Clin Psychopharmacol. 2008;16(5):400-4.
Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113-30.
Chou R, Fanciullo GJ, Fine PG, et al. Opioids for chronic noncancer pain: prediction and identification of aberrant drug-related behaviors: a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10(2):131-46.

Chronic opioid therapy and preventive services in rural primary care: an Oregon rural practice-based research network study.

Buckley DI, Calvert JF, Lapidus JA, et al.
Ann Fam Med. 2010;8(3):237-44.
PURPOSE:...

A different kind of co-morbidity: Understanding posttraumatic stress disorder and chronic pain

Beck JG, Clapp JD.
Psychol Trauma. 2011 Jun;3(2):101-108.
Many traumatic events leave...

The impact of enrollment in a specialized interdisciplinary neuropathic pain clinic

Garven A, Brady S, Wood S, Hatfield M, Bestard J, Korngut L, Toth C.
Pain Res Manag. 2011...

Association between urine drug test results and treatment outcome in high-risk chronic pain patients on opioids

Barth KS, Becker WC, Wiedemer NL, Mavandadi S, Oslin DW, Meghani SH, Gallagher RM.
J Addict...

The role of core strengthening for chronic low back pain.

Akuthota V, Standaert CJ, Chimes GP.
PM R. 2011 Jul;3(7):664-70.