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Opioid addiction, diversion, and abuse in chronic and cancer pain

Kata, Vijaya; Novitch, Matthew B.b; Jones, Mark R.c; Anyama, Best O.d; Helander, Erik M.d; Kaye, Alan D.e

Current Opinion in Supportive and Palliative Care: June 2018 - Volume 12 - Issue 2 - p 124–130
doi: 10.1097/SPC.0000000000000333
PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith

Purpose of review The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy.

Recent findings There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties.

Summary We explore behavioral interventions, provider education, alternative pain management techniques, postmarketing surveillance, and abuse-deterrent formulas as emerging methods to counteract opioid abuse in these populations.

aLouisiana State University Health Sciences Center, New Orleans, Louisiana

bMedical College of Wisconsin, Wausau, Wisconsin

cDepartment of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts

dDepartment of Anesthesiology

eDepartment of Pharmacology, LSUHSC, New Orleans, Louisiana, USA

Correspondence to Alan D. Kaye, MD, PhD, Department of Pharmacology, LSUHSC, 1542 Tulane Avenue, Suite 659, New Orleans, LA 70112, USA. Tel: +1 504 568 2315; e-mail:

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