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      Incidence of tramadol shopping behavior in a retrospective cohort of chronic non-cancer pain patients in France : Tramadol Shopping Behavior in Chronic Pain

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          Abstract

          Opioid analgesic use in chronic non-cancer pain (CNCP) is increasingly prevalent, but the benefits and risks are inadequately understood. In France, tramadol is one of the most used prescription opioids, but studies on its misuse liability in CNCP are still lacking. The aim was to assess the incidence of tramadol shopping behavior in CNCP patients and to identify the associated risk factors.

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          Most cited references51

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          Is Open Access

          Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain.

          Use of chronic opioid therapy for chronic noncancer pain has increased substantially. The American Pain Society and the American Academy of Pain Medicine commissioned a systematic review of the evidence on chronic opioid therapy for chronic noncancer pain and convened a multidisciplinary expert panel to review the evidence and formulate recommendations. Although evidence is limited, the expert panel concluded that chronic opioid therapy can be an effective therapy for carefully selected and monitored patients with chronic noncancer pain. However, opioids are also associated with potentially serious harms, including opioid-related adverse effects and outcomes related to the abuse potential of opioids. The recommendations presented in this document provide guidance on patient selection and risk stratification; informed consent and opioid management plans; initiation and titration of chronic opioid therapy; use of methadone; monitoring of patients on chronic opioid therapy; dose escalations, high-dose opioid therapy, opioid rotation, and indications for discontinuation of therapy; prevention and management of opioid-related adverse effects; driving and work safety; identifying a medical home and when to obtain consultation; management of breakthrough pain; chronic opioid therapy in pregnancy; and opioid-related policies. Safe and effective chronic opioid therapy for chronic noncancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and on the assessment and management of risks associated with opioid abuse, addiction, and diversion. Although evidence is limited in many areas related to use of opioids for chronic noncancer pain, this guideline provides recommendations developed by a multidisciplinary expert panel after a systematic review of the evidence.
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            Relationship between Nonmedical Prescription-Opioid Use and Heroin Use

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              Opioid therapy for chronic pain.

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                Author and article information

                Journal
                Pharmacoepidemiology and Drug Safety
                Pharmacoepidemiol Drug Saf
                Wiley
                10538569
                September 2016
                September 2016
                June 30 2016
                : 25
                : 9
                : 1088-1098
                Affiliations
                [1 ]INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine; Université d'Auvergne; Clermont-Ferrand France
                [2 ]CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV); Service de Pharmacologie Médicale; Clermont-Ferrand France
                [3 ]CHU Clermont-Ferrand; Délégation à la Recherche Clinique et à l'Innovation; Clermont-Ferrand France
                [4 ]CHU Clermont-Ferrand Centre d'Evaluation et de Traitement de la Douleur (CETD); Service de Pharmacologie Médicale; Clermont-Ferrand France
                [5 ]Institut Analgesia, Faculté de Médecine; Clermont-Ferrand France
                Article
                10.1002/pds.4056
                27363310
                7a590b4f-468e-4dfc-afc4-2a973f1ccd79
                © 2016

                http://doi.wiley.com/10.1002/tdm_license_1.1

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