The American Opioid Epidemic: Population Health Implications and Potential Solutions. Report from the National Stakeholder Panel

Clarke, Janice L.; Skoufalos, Alexis; Scranton, Richard E.

doi:10.1089/pop.2015.0144

Cited by 23 publications

(16 citation statements)

References 38 publications

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“…Likewise, we found that opioid medication use did not show significant decrease although reduction tendencies were noted. Given the current state of the opioid epidemic [ 43 , 44 ] and its relevance to the veteran population in particular [ 45 – 47 ], this observation warrants particular attention. Given that opioid dose reduction was not an explicit treatment goal of IPRP, lack of significant decrease in opioid medication use is not surprising.…”

Section: Discussionmentioning

confidence: 99%

An Interdisciplinary Pain Rehabilitation Program for Veterans with Chronic Pain: Description and Initial Evaluation of Outcomes

Anamkath

Palyo

Jacobs

et al. 2018

Pain Research and Management

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Objective Chronic pain conditions are prominent among Veterans. To leverage the biopsychosocial model of pain and comprehensively serve Veterans with chronic pain, the San Francisco Veterans Affairs Healthcare System has implemented the interdisciplinary pain rehabilitation program (IPRP). This study aims to (1) understand initial changes in treatment outcomes following IPRP, (2) investigate relationships between psychological factors and pain outcomes, and (3) explore whether changes in psychological factors predict changes in pain outcomes. Methods A retrospective study evaluated relationships between clinical pain outcomes (pain intensity, pain disability, and opioid use) and psychological factors (depressive symptoms, catastrophizing, and “acceptable” level of pain) and changes in these outcomes following treatment. Multiple regression analysis explored whether changes in psychological variables significantly predicted changes in pain disability. Results Catastrophizing and depressive symptoms were positively related to pain disability, while “acceptable” level of pain was idiosyncratically related to pain intensity. Pain disability and psychological variables showed significant changes in their expected directions. Regression analysis indicated that only changes in depressive symptoms significantly predicted changes in pain disability. Conclusion Our results are consistent with evidence-based clinical practice guidelines for the management of chronic pain in Veterans. Further investigation of interdisciplinary treatment programs in Veterans is warranted.

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Section: Discussionmentioning

confidence: 99%

An Interdisciplinary Pain Rehabilitation Program for Veterans with Chronic Pain: Description and Initial Evaluation of Outcomes

Anamkath

Palyo

Jacobs

et al. 2018

Pain Research and Management

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“…25 The significant increase in opioid prescriptions, combined with a lack of patient support on how to use and wean opioids, has contributed to the alarming rise of the negative individual and social impacts associated with long-term opioid use. [26][27][28] Up to now, most efforts have been concentrated on studying the effects of strategies to reduce the use of opioid in patients already on chronic therapy. 29 Recently, mandatory prescription limits have been associated with a reduction of opioid use after elective surgeries.…”

Section: Open Accessmentioning

confidence: 99%

Strategies aimed at preventing chronic opioid use in trauma and acute care surgery: a scoping review protocol

et al. 2020

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IntroductionGlobally every year, millions of patients sustain traumatic injuries and require acute care surgeries. A high incidence of chronic opioid use (up to 58%) has been documented in these populations with significant negative individual and societal impacts. Despite the importance of this public health issue, optimal strategies to limit the chronic use of opioids after trauma and acute care surgery are not clear. We aim to identify existing strategies to prevent chronic opioid use in these populations.Methods and analysisWe will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify studies, reviews, recommendations and guidelines on strategies aimed at preventing chronic opioid use in patients after trauma and acute care surgery. We will search MEDLINE, EMBASE, PsycINFO, CINHAL, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest and websites of trauma and acute care surgery, pain, government and professional organisations. Databases will be searched for papers published from 1 January 2005 to a maximum of 6 months before submission of the final manuscript. Two reviewers will independently evaluate studies for eligibility and extract data from included studies using a standardised data abstraction form. Preventive strategies will be classified according to their types and targeted trauma populations and acute care surgery procedures.Ethics and disseminationResearch ethics approval is not required as this study is based on the secondary use of published data. This work will inform research and clinical stakeholders on the required next steps towards the uptake of effective strategies aimed at preventing chronic opioid use in trauma and acute care surgery patients.

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“…Opioids are considered an important component of postsurgical pain management 8 and are also known to be a key treatment option for chronic cancer‐related, palliative, or end‐of‐life pain 12 . The use of opioid therapy remains a topic of debate that has been fueled, at least in part, by the dramatic increase in the prescribing, diversion, and misuse of opioids, along with a rise in the incidence of opioid‐related complications and overdose fatalities 13,14 . Opioid dependence—a well‐recognized potential opioid‐related adverse event (ORAE)—can develop even in opioid‐naïve patients 15 .…”

Section: The Need For Improvement In Postsurgical Pain Managementmentioning

confidence: 99%

The Current State of Perioperative Pain Management: Challenges and Potential Opportunities for Nurses

Simpson¹,

Bruckenthal²

2016

AORN Journal

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Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population. Systemic inefficiencies and problematic medical practice patterns can also have negative effects on perioperative pain management. As the surgical patient's primary advocate, perioperative nurses play an important role in overcoming these diverse challenges and addressing the problems associated with inadequately controlled postsurgical pain.

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The American Opioid Epidemic: Population Health Implications and Potential Solutions. Report from the National Stakeholder Panel

Cited by 23 publications

References 38 publications

An Interdisciplinary Pain Rehabilitation Program for Veterans with Chronic Pain: Description and Initial Evaluation of Outcomes

An Interdisciplinary Pain Rehabilitation Program for Veterans with Chronic Pain: Description and Initial Evaluation of Outcomes

Strategies aimed at preventing chronic opioid use in trauma and acute care surgery: a scoping review protocol

The Current State of Perioperative Pain Management: Challenges and Potential Opportunities for Nurses

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