2025
From Chronic Opioids for Pain to Microgram Buprenorphine: Key Factors in an Increasingly Recommended Transition.
Hickey T, Hitt J. From Chronic Opioids for Pain to Microgram Buprenorphine: Key Factors in an Increasingly Recommended Transition. Pain Physician Journal 2025, 28: 59-67. PMID: 39903018.Peer-Reviewed Original ResearchConceptsOpioid therapyBuprenorphine exposureTotal dose of opioidsVeterans Health AdministrationChronic opioid therapyDoses of opioidsChronic pain managementOutpatient opioid prescriptionsReducing opioid useFull-agonist opioidsPrescription of buprenorphineTransition to buprenorphineAssociated with lower oddsVeterans Affairs Corporate Data WarehouseBaseline opioidChronic opioidsOpioid doseAgonist opioidsOpioid exposureHealth AdministrationOpioid prescriptionsOpioid useSurrogate markerLarge-scale observational studiesBuprenorphine initiation
2024
Buprenorphine Facilitates Rapid Weaning From Very-High-Dose Intrathecal Hydromorphone
Hickey T, Manepalli A, Hitt J. Buprenorphine Facilitates Rapid Weaning From Very-High-Dose Intrathecal Hydromorphone. Cureus 2024, 16: e59134. PMID: 38803786, PMCID: PMC11129534, DOI: 10.7759/cureus.59134.Peer-Reviewed Original ResearchPhenomenon of opioid-induced hyperalgesiaPost-laminectomy pain syndromeChronic opioid therapyOpioid-induced hyperalgesiaLow-dose buprenorphineIntrathecal hydromorphoneOpioid escalationOpioid doseOpioid therapyIntrathecal deliveryPain syndromeDaily doseSevere functional limitationsPain managementClinical challengeOpioidPatientsTransition patientsPainBuprenorphineDoseFunctional limitationsHyperalgesiaTherapyHydromorphoneAssessing pain in persons with opioid use disorder: Approaches, techniques and special considerations
Nunes J, Costa G, Weleff J, Rogan M, Compton P, De Aquino J. Assessing pain in persons with opioid use disorder: Approaches, techniques and special considerations. British Journal Of Clinical Pharmacology 2024, 90: 2985-3002. PMID: 38556851, DOI: 10.1111/bcp.16055.Peer-Reviewed Original ResearchOpioid use disorderAssess painPain assessmentPain experienceConcomitant chronic painChronic opioid therapyQuantitative sensory testingVisual analogue scalePain assessment methodsPain assessment toolsComplex psychosocial backgroundImprove pain assessmentOpioid therapyOpioid usePain responseChronic painAnalogue scaleTraditional self-report methodsPainRisk factorsUse disorderOpioidNarrative reviewSelf-report methodsMultidisciplinary team
2022
LBSAT59 Overnight Metyrapone Test And Urine Steroid Profiling In Patients Treated With Chronic Opioid Therapy: Prevalence Of Adrenal Insufficiency
Saini J, Gilliam W, Cunningham J, Thangamuthu K, Gruber L, Singh S, Sutor B, Hooten W, Bancos I. LBSAT59 Overnight Metyrapone Test And Urine Steroid Profiling In Patients Treated With Chronic Opioid Therapy: Prevalence Of Adrenal Insufficiency. Journal Of The Endocrine Society 2022, 6: a45-a46. PMCID: PMC9626924, DOI: 10.1210/jendso/bvac150.094.Peer-Reviewed Original ResearchOpioid-induced adrenal insufficiencyOvernight metyrapone testUrine steroid profileMetyrapone testExposure to opioidsDehydroepiandrosterone sulfateSteroid profileOpioid therapyAdrenal insufficiencyDiagnosis of adrenal disordersPrevalence of adrenal insufficiencyPatients treated with opioidsMorphine milligram equivalents (MME)/dayTreated with high dosesChronic opioid therapyMeasurement of ACTHDehydroepiandrosterone sulfate concentrationsCumulative opioid exposureQuality-of-life surveyChronic opioidsCross-sectional studyOpioid exposureAdrenal disordersSteroid metabolomeDaily MME
2021
Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims
Check DK, Baggett C, Kim K, Roberts AW, Roberts MC, Robinson T, Oeffinger KC, Dinan MA. Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims. Journal Of The National Cancer Institute 2021, 113: 1581-1589. PMID: 33881543, PMCID: PMC8562975, DOI: 10.1093/jnci/djab082.Peer-Reviewed Original ResearchConceptsChronic opioid useChronic opioid therapyOpioid useCancer survivorsOpioid therapyBaseline depressionLong-term pain managementSubstance useRetrospective cohort studyPopulation-based studyCancer registry dataLow-income survivorsCohort studyPatient characteristicsPain managementActive treatmentNonmetastatic cancerChronic useInsurance statusRelative riskRegistry dataOpioidsPoisson regressionYounger ageAge groups
2019
Prescription Opioid Misuse Index in sickle cell patients: A brief questionnaire to assess at-risk for opioid abuse.
Smith WR, McClish DK, Roberts JD, Kandalaft O, Dahman B, Knisely J, Levenson J, Roseff S, Aisiku IP. Prescription Opioid Misuse Index in sickle cell patients: A brief questionnaire to assess at-risk for opioid abuse. Journal Of Opioid Management 2019, 15: 323-331. PMID: 31637684, DOI: 10.5055/jom.2019.0517.Peer-Reviewed Original ResearchConceptsOpioid misuseOpioid abuseAdult sickle cell disease patientsPrescription Opioid Misuse IndexSickle cell disease patientsAdult SCD patientsChronic opioid therapyGroup of patientsSickle cell clinicSickle cell patientsDiagnostic Interview ScheduleDSM-IV criteriaUrban teaching facilityOpioid therapySCD clinicOpioid usageAdult patientsRisk patientsSecondary outcomesHemoglobin SSPrimary outcomeSCD patientsMean ageDisease patientsProspective survey
2017
Safe Opioid Prescribing and Controlled Substance Policies
Tobin D, Barrette E. Safe Opioid Prescribing and Controlled Substance Policies. 2017, 157-180. DOI: 10.1007/978-3-319-68267-9_14.Chapters
2016
Breaking the pain contract: A better controlled-substance agreement for patients on chronic opioid therapy
Tobin DG, Keough Forte K, Johnson McGee S. Breaking the pain contract: A better controlled-substance agreement for patients on chronic opioid therapy. Cleveland Clinic Journal Of Medicine 2016, 83: 827-835. PMID: 27824537, DOI: 10.3949/ccjm.83a.15172.Peer-Reviewed Original ResearchCo-Prescription of Naloxone as a Universal Precautions Model for Patients on Chronic Opioid Therapy—Observational Study
Takeda M, Katzman J, Dole E, Bennett M, Alchbli A, Duhigg D, Yonas H. Co-Prescription of Naloxone as a Universal Precautions Model for Patients on Chronic Opioid Therapy—Observational Study. Substance Abuse 2016, 37: 591-596. PMID: 27093555, DOI: 10.1080/08897077.2016.1179704.Peer-Reviewed Original ResearchConceptsCurrent Opioid Misuse Measure scoreChronic opioid therapyMorphine equivalent doseAmbulatory clinic settingOpioid overdoseInterdisciplinary team of health care professionalsTeam of health care professionalsParadigm of harm reductionPatients prescribed chronic opioid therapyHealth care providersHealth care professionalsUnintentional opioid overdose deathsCo-prescribedPrescription opioid overdosePublic health interventionsOpioid misuse riskNaloxone rescue kitsRisk of opioid overdosePressing public health problemsMedian morphine equivalent doseAberrant drug-related behaviorsAcademic medical centerChronic noncancer painClinical settingPublic health problemPrescribing opioids in primary care: Safely starting, monitoring, and stopping
Tobin DG, Andrews R, Becker WC. Prescribing opioids in primary care: Safely starting, monitoring, and stopping. Cleveland Clinic Journal Of Medicine 2016, 83: 207-215. PMID: 26974992, DOI: 10.3949/ccjm.83a.15034.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic opioid therapyChronic noncancer painPrimary care providersPrescription drug abuseNoncancer painOpioid therapyOpioid misusePrimary careCare teamCare providersEpidemic proportionsMeaningful benefitPatient communicationOpioidsDrug abuseAdverse effectsAbusePainOutpatientsPatientsTherapyCareA Chronic Opioid Therapy Dose Reduction Policy in Primary Care
Weimer MB, Hartung DM, Ahmed S, Nicolaidis C. A Chronic Opioid Therapy Dose Reduction Policy in Primary Care. Substance Abuse 2016, 37: 141-147. PMID: 26685018, DOI: 10.1080/08897077.2015.1129526.Peer-Reviewed Original ResearchConceptsHigh-dose opioidsChronic opioid therapyOpioid therapyOpioid doseDose taperAcademic primary care clinicHigh-dose opioid therapyHigher opioid doseIntervention of educationOpioid dose reductionTotal opioid doseRetrospective cohort studyCharacteristics of patientsPrimary care clinicsOpioid use disorderMedication-Assisted TreatmentAverage daily doseOnly significant associationMorphine equivalentsOpioid dosesCohort studyPatient characteristicsDaily doseCare clinicsChronic pain
2013
Sex Differences in the Medical Care of VA Patients with Chronic Non-Cancer Pain
Weimer MB, Macey TA, Nicolaidis C, Dobscha SK, Duckart JP, Morasco BJ. Sex Differences in the Medical Care of VA Patients with Chronic Non-Cancer Pain. Pain Medicine 2013, 14: 1839-1847. PMID: 23802846, PMCID: PMC3866355, DOI: 10.1111/pme.12177.Peer-Reviewed Original ResearchConceptsChronic opioid therapyPain-related diagnosesPrimary care utilizationChronic painOpioid therapyCare utilizationEmergency departmentGreater oddsSevere chronic non-cancer painFemale veteransChronic non-cancer painSex differencesNon-cancer painRetrospective cohort studyInflammatory bowel diseasePhysical therapy referralsLow back painVeterans Affairs systemMultivariate logistic regressionPain-related complaintsVA administrative dataMental health diagnosesSubstance use disordersMore pain conditionsMedical comorbiditiesError and Bias in the Evaluation of Prescription Opioid Misuse: Should the FDA Regulate Clinical Assessment Tools?
Meltzer E, Hall W, Fins J. Error and Bias in the Evaluation of Prescription Opioid Misuse: Should the FDA Regulate Clinical Assessment Tools? Pain Medicine 2013, 14: 982-987. PMID: 23594383, DOI: 10.1111/pme.12099.Peer-Reviewed Original ResearchConceptsFood and Drug AdministrationClinical assessment toolScreening toolAssessment toolOpioid-related aberrant behaviorsAberrant medication-related behaviorsOpioid-related risksChronic opioid therapyPrescription opioid misusePredictive of addictionMedication-related behaviorsOpioid therapyPain medicationStandardized questionnaireOpioid misuseIdentified patientsAt-riskDrug AdministrationDiagnose illnessAddictive disordersPatientsAberrant behaviorScreeningComprehensive planAddictionRisks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use
Gudin JA, Mogali S, Jones JD, Comer SD. Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use. Postgraduate Medicine 2013, 125: 115-130. PMID: 23933900, PMCID: PMC4057040, DOI: 10.3810/pgm.2013.07.2684.Peer-Reviewed Original ResearchConceptsChronic opioid therapyUrine drug testingOpioid analgesicsChronic painOpioid therapyAberrant drug-related behaviorsAlcohol useOpioid-related abuseAdjustment of treatmentDrug testingTherapeutic drug monitoringDrug-related behaviorsCombination opioidsAdverse eventsNonfatal overdoseSedative agentsTreatment complianceClinical changesPatient outcomesBZD treatmentAberrant behaviorPractice guidelinesHigh riskClose monitoringPain
2011
Measurement of adherence to clinical practice guidelines for opioid therapy for chronic pain
Midboe AM, Lewis ET, Paik MC, Gallagher RM, Rosenberg JM, Goodman F, Kerns RD, Becker WC, Trafton JA. Measurement of adherence to clinical practice guidelines for opioid therapy for chronic pain. Translational Behavioral Medicine 2011, 2: 57-64. PMID: 24073098, PMCID: PMC3717811, DOI: 10.1007/s13142-011-0104-5.Peer-Reviewed Original ResearchClinical practice guidelinesOpioid therapyChronic painPractice guidelinesDefense Clinical Practice GuidelineVeterans Affairs/DepartmentChronic opioid therapyPatient-oriented interventionsMeasurement of adherenceHealth care prioritiesSystem-level factorsQuality improvement approachEffective prescribingCare prioritiesTherapyPainAdherenceLevel factorsDepartmentGuidelinesPrescribingProblematic use
2009
Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P, Donovan MI, Fishbain DA, Foley KM, Fudin J, Gilson AM, Kelter A, Mauskop A, O'Connor PG, Passik SD, Pasternak GW, Portenoy RK, Rich BA, Roberts RG, Todd KH, Miaskowski C, Panel A. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. Journal Of Pain 2009, 10: 113-130.e22. PMID: 19187889, PMCID: PMC4043401, DOI: 10.1016/j.jpain.2008.10.008.Peer-Reviewed Original ResearchConceptsChronic opioid therapyChronic noncancer painOpioid therapyNoncancer painMultidisciplinary expert panelExpert panelSystematic reviewHigh-dose opioid therapyOpioid-related adverse effectsAdverse effectsOpioid management plansDiscontinuation of therapyAmerican Pain SocietyUse of opioidsUse of methadoneMonitoring of patientsOpioid rotationBreakthrough painOpioid prescribingDose escalationPain SocietyPatient selectionRisk stratificationClinical guidelinesOpioid abuse
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