Ambulatory diagnosis and treatment of nonmalignant pain in the united states, 2000-2010
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Cites background from "Ambulatory diagnosis and treatment ..."
...Despite these risks and the lack of evidence supporting long-term efficacy, OPR prescribing for chronic non-cancer pain increased over the past decade while use of nonopioid analgesics decreased (20)....
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...Chronic pain is one of the most common reasons for seeking medical attention in the United States, and prescription opioids are frequently prescribed to manage pain (12)....
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References
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"Ambulatory diagnosis and treatment ..." refers background in this paper
...By 2008, the annual number of fatal drug poisonings surpassed those of motor vehicle deaths(15) and overdose deaths attributable to prescription drugs exceeded those of cocaine and heroin combined.(16) The epidemic of prescription drug abuse in the United States has renewed the challenge of appropriate identification and management of pain in ambulatory settings....
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...However, there is little evidence to support any greater safety or effectiveness of opioids over many of these alternative analgesics, particularly with respect to functional outcomes and longer term use.(27) Indeed, despite large escalations in clinical adoption, trials of opioids have generally been placebo-controlled, examined only short-term outcomes, and excluded patients with a history of substance abuse, depression, or other mental illness....
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"Ambulatory diagnosis and treatment ..." refers background in this paper
...This is particularly important because of the variety of alternative pharmacologic treatments available to treat nonmalignant pain, including selective and nonselective NSAIDs, acetaminophen, some anticonvulsants, tricyclic antidepressants, and in the case of musculoskeletal pain, muscle relaxants, topical analgesics and local injections.(1,26) The removal of rofecoxib from the market in 2004 may have increased providers’ awareness of adverse events related to NSAIDs and thus contributed to the decrease in NSAID use for the treatment of musculoskeletal pain....
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