Expert Decision Making on Opioid Treatment

Book excerpt: Over the last several decades opioid treatment for chronic pain has become increasingly popular. From the sense that chronic pain had previously been undertreated, to drug companies anxious to sell new "designer" opioids, usage has increased several-fold. In its unfortunate history non-specialists were persuaded to prescribe opioids before they could possibly understand the complexity of the treatment. So great were the pressures to prescribe, opioids were prescribed indiscriminately. It became almost impossible to deny opioids without seeming inhumane. While carefully selected and managed opioid therapy can benefit certain patients, casual use fails in several respects. A vast educational effort is needed to help clinicians understand the complexities of opioid therapy. Expert Decision Making on Opioid Treatment explains to readers how to select patients, and subsequently manage and monitor, so as to achieve continued efficacy without losing control of pain and drug use. This book aims to provide clinicians with expert opinion on how to manage common scenarios involving opioid management of chronic pain. It will provide the reader not only with an easy reference to the management of common clinical scenarios where opioids are involved, but also with in depth analysis of the difficult issues surrounding a treatment that is both uniquely effective and potentially harmful.