PMID- 26000678
OWN - NLM
STAT- MEDLINE
DCOM- 20151230
LR  - 20220311
IS  - 2150-1149 (Electronic)
IS  - 1533-3159 (Linking)
VI  - 18
IP  - 3
DP  - 2015 May-Jun
TI  - Reducing opioid analgesic deaths in America: what health providers can do.
PG  - E307-22
AB  - BACKGROUND: Available data have shown steady increases of drug overdose deaths 
      between 1992 and 2011. We review evidenced-based recommendations provided by a 
      few prominent North American pain societies and suggest ways on how health 
      providers might help reduce opioid analgesic deaths by implementing these 
      practices. OBJECTIVE: To identify health care providers' roles in reducing opioid 
      analgesic deaths. STUDY DESIGN: A comprehensive review of current literature. 
      METHODS: The review included relevant literature identified through searches of 
      MEDLINE, Cochran reviews, and Google Scholar, PubMed and EMBASE from January 1998 
      to January 2014. The level of evidence was classified as I (good), II (fair), and 
      III (limited) based on the quality of evidence developed by the U.S. Preventive 
      Services Task Force (USPSTF). RESULTS: Several practices such as too high doses 
      overall, giving too high doses to opioid naive patients, too fast opioid 
      titration, insufficient use and knowledge of urine drug testing, not updating 
      knowledge of drug metabolism/interactions, and inadequate patient monitoring are 
      associated with higher risks of opioid analgesic deaths. Suboptimal risk 
      stratification of patients, rotation practices, and use of opioids analgesics in 
      chronic noncancer pain are also associated factors. LIMITATIONS: There were a 
      paucity of good evidence studies which show recommendations reduce death. 
      CONCLUSION: Providers should be aware of all associated factors with opiate 
      analgesic deaths and apply the available evidence in reducing opioid analgesic 
      deaths.
FAU - Agarin, Taghogho
AU  - Agarin T
AD  - UCSD Center for Pain Medicine, La Jolla CA; Algone Pain Center, Wasila, Alaska; 
      Dept. of Psychiatry, University of California, San Diego; Dept. Of Psychiatry, 
      Harlem Hospital, Columbia University, NY.
FAU - Trescot, Andrea M
AU  - Trescot AM
FAU - Agarin, Aniefiok
AU  - Agarin A
FAU - Lesanics, Doreena
AU  - Lesanics D
FAU - Decastro, Claricio
AU  - Decastro C
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Pain Physician
JT  - Pain physician
JID - 100954394
RN  - 0 (Analgesics)
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Analgesics/therapeutic use
MH  - Analgesics, Opioid/*adverse effects/therapeutic use
MH  - Chronic Pain/*drug therapy/*mortality
MH  - Drug Overdose/*mortality/prevention & control
MH  - *Health Personnel/standards
MH  - Humans
MH  - Pain/drug therapy/mortality
MH  - Substance Abuse Detection/methods/mortality/standards
MH  - United States/epidemiology
EDAT- 2015/05/23 06:00
MHDA- 2015/12/31 06:00
CRDT- 2015/05/23 06:00
PHST- 2015/05/23 06:00 [entrez]
PHST- 2015/05/23 06:00 [pubmed]
PHST- 2015/12/31 06:00 [medline]
PST - ppublish
SO  - Pain Physician. 2015 May-Jun;18(3):E307-22.