2023
Is psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders?
Manhapra A, Zhou B, Rhee T, Rosenheck R. Is psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders? Journal Of Affective Disorders 2023, 344: 585-591. PMID: 37863364, DOI: 10.1016/j.jad.2023.10.094.Peer-Reviewed Original ResearchMeSH KeywordsAdultChronic PainComorbidityHealth SurveysHumansMental DisordersPrevalenceSubstance-Related DisordersConceptsLifetime psychiatric disordersPast-year psychiatric disordersSevere pain interferencePain interferencePsychiatric disordersPD remissionChronic painNon-substance use psychiatric disordersPrevalence of painMental functioningLower physical functioningNational Epidemiologic SurveyRelated Conditions-IIIPoor mental functioningCommon comorbiditiesPhysical functionAdjusted oddsPhysical functioningObservational studyReduced prevalenceRemissionUS adultsDiagnostic remissionEpidemiologic SurveyPain
2022
Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome
Manhapra A. Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome. Current Treatment Options In Oncology 2022, 23: 921-935. PMID: 35435616, DOI: 10.1007/s11864-022-00985-x.Peer-Reviewed Original ResearchConceptsChronic pain syndromeOpioid dependenceOpioid taperingPain syndromeClinical conundrumLong-term opioid useWorse pain controlNon-cancer painOpioid use disorderPoor patient acceptanceSeparate clinical entityAnti-reward systemsOpioid doseOpioid therapyPain providersPain controlOpioid usePain mechanismsClinical entityMore painIatrogenic problemsPatient acceptanceTreatment choiceChronic cancerPain experience
2020
Complex Persistent Opioid Dependence with Long-term Opioids: a Gray Area That Needs Definition, Better Understanding, Treatment Guidance, and Policy Changes
Manhapra A, Sullivan MD, Ballantyne JC, MacLean RR, Becker WC. Complex Persistent Opioid Dependence with Long-term Opioids: a Gray Area That Needs Definition, Better Understanding, Treatment Guidance, and Policy Changes. Journal Of General Internal Medicine 2020, 35: 964-971. PMID: 33159241, PMCID: PMC7728942, DOI: 10.1007/s11606-020-06251-w.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid taperingOpioid dependenceChronic pain refractoryUtilization of buprenorphineLong-term opioidsSevere chronic painOpioid use disorderMultitude of treatmentsLimited supportive evidenceOpioid therapyPain refractoryBuprenorphine treatmentChronic painClinical instabilityRecent guidelinesClinical definitionUS adultsUse disordersDiagnosis/Treatment guidancePainComplicationsTreatmentSupportive evidenceNonconsensual Dose Reduction Mandates are Not Justified Clinically or Ethically: An Analysis
Kertesz S, Manhapra A, Gordon A. Nonconsensual Dose Reduction Mandates are Not Justified Clinically or Ethically: An Analysis. The Journal Of Law, Medicine & Ethics 2020, 48: 259-267. PMID: 32631183, PMCID: PMC7938366, DOI: 10.1177/1073110520935337.Peer-Reviewed Original Research
2019
Systematic Review of Pain Severity and Opioid Craving in Chronic Pain and Opioid Use Disorder
MacLean RR, Spinola S, Manhapra A, Sofuoglu M. Systematic Review of Pain Severity and Opioid Craving in Chronic Pain and Opioid Use Disorder. Pain Medicine 2019, 21: e146-e163. PMID: 32034413, DOI: 10.1093/pm/pnz228.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid use disorderChronic painPain severityOpioid therapyOpioid cravingUse disordersEligible studiesSystematic reviewOpioid use disorder patientsChronic pain populationsRisk of biasInclusion/exclusion criteriaPain populationObservational studyExclusion criteriaPainDisorder patientsPsycINFO databasesTherapyMean levelsDisordersSeverityStudy of individualsCraving
2018
Multimodal Treatment Options, Including Rotating to Buprenorphine, Within a Multidisciplinary Pain Clinic for Patients on Risky Opioid Regimens: A Quality Improvement Study
Oldfield BJ, Edens EL, Agnoli A, Bone CW, Cervone DJ, Edmond SN, Manhapra A, Sellinger JJ, Becker WC. Multimodal Treatment Options, Including Rotating to Buprenorphine, Within a Multidisciplinary Pain Clinic for Patients on Risky Opioid Regimens: A Quality Improvement Study. Pain Medicine 2018, 19: s38-s45. PMID: 30203007, DOI: 10.1093/pm/pny086.Peer-Reviewed Original ResearchConceptsPrimary care providersIntake appointmentMorphine equivalent daily dosePartial opioid agonist buprenorphineVeterans Health Administration hospitalsPartial agonist therapiesPrescribed opioid dosesRetrospective cohort studyUnsafe useEquivalent daily doseMultidisciplinary pain clinicMultimodal treatment optionsChronic pain managementPrimary care settingQuality improvement studyHealth system levelHealth system improvementOpioid dosesCohort studyPain clinicDaily doseOpioid regimensPain managementMultidisciplinary clinicTreatment optionsThe Conundrum of Opioid Tapering in Long-Term Opioid Therapy for Chronic Pain: A Commentary
Manhapra A, Arias A, Ballantyne J. The Conundrum of Opioid Tapering in Long-Term Opioid Therapy for Chronic Pain: A Commentary. Substance Abuse 2018, 39: 152-161. PMID: 28929914, PMCID: PMC6129223, DOI: 10.1080/08897077.2017.1381663.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid taperingChronic painOpioid therapyOpioid dependencePsychiatric symptomsHigher-dose long-term opioid therapyClinical scenariosPoor pain controlTerm opioid therapyUse of opioidsDifficult clinical scenariosUnique clinical challengesOpioid needsPain controlNeuroplasticity effectsAbstinence syndromeFunctional statusOpioid epidemicClinical challengeFunctional declinePainAffective symptomsPsychiatric instabilityAvailable evidence