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Ambulatory diagnosis and treatment of nonmalignant pain in the united states, 2000-2010

TLDR
Increased opioid prescribing has not been accompanied by similar increases in nonopioid analgesics or the proportion of ambulatory pain patients receiving pharmacologic treatment, suggesting clinical alternatives to prescription opioids may be underutilized as a means of treating ambulatory nonmalignant pain.
Abstract
Background:Escalating rates of prescription opioid use and abuse have occurred in the context of efforts to improve the treatment of nonmalignant pain.Objective:The aim of the study was to characterize the diagnosis and management of nonmalignant pain in ambulatory, office-based settings in the Unit

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Managing Multiple Goals in Opioid Prescription Communication: Perspectives from Trauma Physicians

TL;DR: This study examines the prescribing practices of trauma surgeons who enter patient consultations with multiple and conflicting goals respective to their roles as a healers of the suffering, regulators of illicit substances, members of a medical system working to contain an opioid epidemic, and moral beings with a distinct set of experiences and practice philosophies.
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Influence of Primary Care Provider Type on Chronic Pain Management Among Veterans.

TL;DR: In this paper , the authors compared opioid and non-opioid prescribing patterns of physicians, nurse practitioners, and physician assistants for chronic pain patients at VHA centers using data from the U.S. Department of Veterans Affairs Survey of Healthcare Experience of Patients and Corporate Data Warehouse from October 2015 to September 2016.
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Simple screening model for identifying the risk of sleep apnea in patients on opioids for chronic pain

TL;DR: In this paper, a simple model using the STOP-Bang questionnaire and resting daytime SpO2, followed by overnight oximetry, can identify those at high risk of moderate-to-severe sleep apnea in patients using opioids for chronic pain.
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PRescribing interventions for chronic pain using the electronic health record (PRINCE): Study protocol.

TL;DR: In this paper , the authors used a cluster-randomized 2 × 2 factorial design to test the effects of two behavioral economics-informed interventions embedded within the electronic health record (EHR) on guideline-concordant pain treatment and opioid prescribing decisions in primary care settings.
References
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Vital Signs: Overdoses of Prescription Opioid Pain Relievers - United States, 1999-2008

TL;DR: Wide variation among states in the nonmedical use of OPR and overdose rates cannot be explained by underlying demographic differences in state populations but is related to wide variations in OPR prescribing.
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Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects

TL;DR: Weak and strong opioids outperformed placebo for pain and function in all types of CNCP and were significantly superior to naproxen and nortriptyline, and only for pain relief.
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Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.

TL;DR: This systematic review and meta-analysis addresses the following questions: Are opioid medications effective in treating chronic back pain?
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Treatment of chronic non-cancer pain

TL;DR: A general overview of empirical evidence for the most commonly used interventions in the management of chronic non-cancer pain, including pharmacological, interventional, physical, psychological, rehabilitative, and alternative modalities is provided.
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Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids.

TL;DR: Therapeutic opioid use has increased substantially, specifically of Schedule II drugs, and patients on long-term opioid use have been shown to increase the overall cost of healthcare, disability, rates of surgery, and late opioid use.
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