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10.3238/arztebl.2016.0213 http://scihub22266oqcxt.onion/10.3238/arztebl.2016.0213 C4857553!4857553!27120492     free     free     free Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Dtsch+Arztebl+Int 2016 ; 113 (13): 213-20 Nephropedia Template TP {{tp|p=27120492|t=2016. Dependence on Prescription Opioids: Prevention, Diagnosis and Treatment |pdf=|usr=}}{{27120492}} gab.com Text Dependence on Prescription Opioids: Prevention, Diagnosis and Treatment JO: Dtsch Arztebl Int http://www.kidney.de/pget.php?&tw=1&pmid=27120492 #FOAvip Background: The incidence of initial prescriptions of opioids for chronic non-cancer pain rose by 37% in Germany from 2000 to 2010. Prescribing practice does not always conform with the recommendations of current guidelines. In the USA, 8?12% of patients with chronic non-cancer pain are opioid-dependent. Methods: This review is based on publications retrieved by a selective PubMed search and on the German S3 guideline on the long-term use of opioids in non-cancer pain. Results: Patients must be informed and counseled about the effects and risks of opioids before these drugs are prescribed. All opioid prescriptions for patients with chronic non-cancer pain should be regularly reviewed. The risk of abuse is high in young adults (odds ratio [OR] = 6.74) and in those with a history of substance abuse (OR = 2.34). Any unusual medication-related behavior, e.g., loss of prescriptions or increasing the dose without prior discussion with the physician, calls for further assessment by the physician in conversation with the patient. Urine testing for drugs and their metabolites is helpful as well. The goal of treatment of opioid abuse is opioid abstinence by gradual reduction of the dose. If this is not possible on an outpatient basis, hospitalization for drug withdrawal or substitution-based addiction therapy can be offered. Conclusion: Physicians who know the indications and risks of opioid therapy and the typical behavior of drug-dependent patients will be better able to identify patients at risk and to prevent dependence. Studies on the prevalence of opioid abuse and dependence in German patients with chronic pain can help provide better estimates of the current extent and implications of this problem in Germany. Twit Text FOAVip Dependence on Prescription Opioids: Prevention, Diagnosis and Treatment ????Dtsch Arztebl Int http://www.kidney.de/pget.php?&tw=1&pmid=27120492 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27120492 #FOAvip English Wikipedia <ref>{{Cite pmid|27120492}}</ref> Dependence on Prescription Opioids: Prevention, Diagnosis and Treatment #MMPMID27120492 Just J; Mücke M; Bleckwenn M Dtsch Arztebl Int 2016[Apr]; 113 (13): 213-20 PMID27120492show ga Background: The incidence of initial prescriptions of opioids for chronic non-cancer pain rose by 37% in Germany from 2000 to 2010. Prescribing practice does not always conform with the recommendations of current guidelines. In the USA, 8?12% of patients with chronic non-cancer pain are opioid-dependent. Methods: This review is based on publications retrieved by a selective PubMed search and on the German S3 guideline on the long-term use of opioids in non-cancer pain. Results: Patients must be informed and counseled about the effects and risks of opioids before these drugs are prescribed. All opioid prescriptions for patients with chronic non-cancer pain should be regularly reviewed. The risk of abuse is high in young adults (odds ratio [OR] = 6.74) and in those with a history of substance abuse (OR = 2.34). Any unusual medication-related behavior, e.g., loss of prescriptions or increasing the dose without prior discussion with the physician, calls for further assessment by the physician in conversation with the patient. Urine testing for drugs and their metabolites is helpful as well. The goal of treatment of opioid abuse is opioid abstinence by gradual reduction of the dose. If this is not possible on an outpatient basis, hospitalization for drug withdrawal or substitution-based addiction therapy can be offered. Conclusion: Physicians who know the indications and risks of opioid therapy and the typical behavior of drug-dependent patients will be better able to identify patients at risk and to prevent dependence. Studies on the prevalence of opioid abuse and dependence in German patients with chronic pain can help provide better estimates of the current extent and implications of this problem in Germany. äDependence on Prescription Opioids: Prevention, Diagnosis and Treatmen(epmc).pdf DeepDyve Pubget Overpricing