Linked Life Data

21970125

Source:http://linkedlifedata.com/resource/pubmed/id/21970125

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2011-10-5
pubmed:abstractText
In Australia and New Zealand, in parallel with other developed countries, the number of patients prescribed opioids on a long-term basis has grown rapidly over the last decade. The burden of chronic pain is more widely recognised and there has been an increase in the use of opioids for both cancer and non-cancer indications. While the prevalence of illicit opioid use has remained relatively stable, the diversion and abuse of prescription opioids has escalated, as has the number of individuals receiving methadone or buprenorphine pharmacotherapy for opioid addiction. As a result, the proportion of opioid-tolerant patients requiring acute pain management has increased, often presenting clinicians with greater challenges than those faced when treating the opioid-naïve. Treatment aims include effective relief of acute pain, prevention of drug withdrawal, assistance with any related social, psychiatric and behavioural issues, and ensuring continuity of long-term care. Pharmacological approaches incorporate the continuation of usual medications (or equivalent), short-term use of sometimes much higher than average doses of additional opioid, and prescription of non-opioid and adjuvant drugs, aiming to improve pain relief and attenuate opioid tolerance and/or opioid-induced hyperalgesia. Discharge planning should commence at an early stage and may involve the use of a 'Reverse Pain Ladder' aiming to limit duration of additional opioid use. Legislative requirements may restrict which drugs can be prescribed at the time of hospital discharge. At all stages, there should be appropriate and regular consultation and liaison with the patient, other treating teams and specialist services.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0310-057X
pubmed:author
pubmed:issnType
Print
pubmed:volume
39
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
804-23
pubmed:meshHeading
pubmed-meshheading:21970125-Acute Disease, pubmed-meshheading:21970125-Analgesics, pubmed-meshheading:21970125-Analgesics, Opioid, pubmed-meshheading:21970125-Animals, pubmed-meshheading:21970125-Australia, pubmed-meshheading:21970125-Buprenorphine, pubmed-meshheading:21970125-Drug Tolerance, pubmed-meshheading:21970125-Humans, pubmed-meshheading:21970125-Hyperalgesia, pubmed-meshheading:21970125-Methadone, pubmed-meshheading:21970125-Naloxone, pubmed-meshheading:21970125-Narcotic Antagonists, pubmed-meshheading:21970125-Narcotics, pubmed-meshheading:21970125-New Zealand, pubmed-meshheading:21970125-Opiate Substitution Treatment, pubmed-meshheading:21970125-Opioid-Related Disorders, pubmed-meshheading:21970125-Pain, pubmed-meshheading:21970125-Pain, Postoperative, pubmed-meshheading:21970125-Patient Discharge, pubmed-meshheading:21970125-Preoperative Care, pubmed-meshheading:21970125-Street Drugs, pubmed-meshheading:21970125-Substance Withdrawal Syndrome
pubmed:year
2011
pubmed:articleTitle
Acute pain management in opioid-tolerant patients: a growing challenge.
pubmed:affiliation
Department of Anaesthesia, Pain Medicine and Hyperbaric Medicine, Royal Adelaide Hospital, Adelaide, South Australia christine.huxtable@health.sa.gov.au
pubmed:publicationType
Journal Article, Review, Research Support, Non-U.S. Gov't