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Addiction Issues in Prescribing Opioids for Chronic Nonmalignant Pain

Weaver, Michael MD; Schnoll, Sidney MD, PhD

Journal of Addiction Medicine: March 2007 - Volume 1 - Issue 1 - p 2-10
doi: 10.1097/ADM.0b013e3180473bec
Review Article

This article provides an overview of central issues in chronic nonmalignant pain management with a focus on prescribing opioid analgesics. Definitions are provided for terminology regarding pain and addiction. Epidemiology of addiction among patients with chronic nonmalignant pain is reviewed. Benefits and complications of opioid therapy are discussed, along with recent regulatory issues for prescribers and use of medication agreements. Nonopioid treatments are reviewed. A standardized approach to chronic nonmalignant pain reduces stigma and improves patient care, therefore, an algorithm is presented for management of chronic nonmalignant pain.

From the Department of Internal Medicine and Psychiatry (MW, SS), Virginia Commonwealth University, Richmond, VA; and Pinney Associates (SS), Bethesda, MD.

Received November 30, 2006; revised February 6, 2007; accepted February 7, 2007.

Send correspondence and reprint requests to Dr. Michael Weaver, Virginia Commonwealth University, P.O. Box 980109, Richmond, VA 23298-0109. e-mail:

© 2007 American Society of Addiction Medicine