{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:46:13Z","timestamp":1788511573355,"version":"build-2803163510"},"reference-count":65,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T00:00:00Z","timestamp":1531094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This is an article in the Core Entrustables in Clinical Pharmacology series that describes opioid therapy in acute and chronic pain. Opioid use during surgical procedures or anesthesia is not discussed. Basic pharmacokinetic and pharmacodynamic properties of opioids are reviewed. The safe and effective use of opioids, including clinical assessment and treatment plan, equianalgesic dosing, opioid rotation, opioid risks and side effects, and clinical adherence monitoring are discussed. Individualized opioid use can be a safe and effective component of a patient\u2010specific multimodal treatment plan for acute or chronic pain. Adverse effects and risks can be prevented or effectively managed when anticipated and recognized. The article is followed by 4 clinical vignettes with discussions.<\/jats:p>","DOI":"10.1002\/jcph.1276","type":"journal-article","created":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T14:05:10Z","timestamp":1531145110000},"page":"1111-1122","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":126,"title":["Opioid Therapy in Acute and Chronic Pain"],"prefix":"10.1002","volume":"58","author":[{"given":"Anne N.","family":"Nafziger","sequence":"first","affiliation":[{"name":"Bertino Consulting  Schenectady NY USA"},{"name":"School of Pharmacy &amp; Pharmaceutical Sciences Department of Pharmacy Practice University at Buffalo State University of New York  Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Barkin","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology Pharmacology, and Family Medicine Rush Medical College Rush University  Chicago IL USA"},{"name":"Department of Anesthesiology Pain Centers of Evanston and Skokie Hospitals of NorthShore University Health System Evanston and Skokie  IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,9]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"569","volume-title":"Goodman & Gilman's The Pharmacological Basis of Therapeutics","author":"Gutstein H","year":"2001"},{"key":"e_1_2_10_3_1","first-page":"255","volume-title":"Goodman and Gilman's The Pharmacological Basis of Therapeutics","author":"Yaksh T","year":"2017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6501e1"},{"issue":"11","key":"e_1_2_10_5_1","first-page":"295","volume":"65","author":"Errata","year":"2016","journal-title":"MMWR Morbid Mortal Wkly Rep"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2017.s92"},{"issue":"3","key":"e_1_2_10_7_1","first-page":"S1","article-title":"American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non\u2010cancer pain: Part I\u2014evidence assessment","volume":"15","author":"Manchikanti L","year":"2012","journal-title":"Pain Physician"},{"issue":"3","key":"e_1_2_10_8_1","first-page":"S67","article-title":"American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non\u2010cancer pain: Part 2\u2014guidance","volume":"15","author":"Manchikanti L","year":"2012","journal-title":"Pain Physician"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","unstructured":"FDA.Draft Revisons to the FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain U.S. Food and Drug Administration.2017.https:\/\/doi.org\/10.15585\/mmwr.mm655051e1","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"issue":"1","key":"e_1_2_10_11_1","first-page":"35","volume":"66","author":"Erratum","year":"2017","journal-title":"MMWR Morbid Mortal Wkly Rep"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.1088"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.clpt.6100095"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2008.0018"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.771"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31817e13cc"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.676"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.2980"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2008.00204.x"},{"issue":"5","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1001\/virtualmentor.2013.15.5.pfor1-1305","article-title":"Pain and ethnicity","volume":"15","author":"Wyatt R","year":"2013","journal-title":"AMA J Ethics"},{"key":"e_1_2_10_21_1","volume-title":"Extended\u2010Release (ER) and Long\u2010Acting (LA) Opioid Analgesics Risk Evaluation and Mitigation Strategy (REMS)","author":"FDA","year":"2015"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.07.010"},{"key":"e_1_2_10_23_1","first-page":"1","volume-title":"NUCYNTA\u00ae (tapentadol) package insert","year":"2016"},{"key":"e_1_2_10_24_1","unstructured":"Pain Treatment with Opioid Medications: Patient Agreement. Sample patient treatment agreement for opioid use.https:\/\/www.drugabuse.gov\/sites\/default\/files\/files\/SamplePatientAgreementForms.pdf. Accessed April 13 2018."},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170363"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1507771"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.2001.81.1.299"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2017.0378"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200309000-00002"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/J354v19n04_05"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.002"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2008.10.008"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550880802122570"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00271-8"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.001"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.004"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2011\/14\/E343"},{"issue":"4","key":"e_1_2_10_38_1","first-page":"394","article-title":"Pain management in advanced cancer","volume":"12","author":"Levy MH","year":"1985","journal-title":"Semin Oncol"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199505000-00018"},{"key":"e_1_2_10_40_1","first-page":"589","article-title":"Toward a systematic approach to opioid rotation","volume":"7","author":"Smith HS","year":"2014","journal-title":"J Pain Res"},{"key":"e_1_2_10_41_1","unstructured":"FDA Advisory Committee on the Most Appropriate Dose or Doses of Naloxone to Reverse the Effects of Life\u2010Threatening Opioid Overdose in the Community Settings.Joint Meeting of the Anesthetic and Analgesic Drug Products Advisory Committee and the Drug Safety and Risk Management Advisory Committee on October 5 20162016; Advisory Committee Briefing Materials.https:\/\/www.fda.gov\/downloads\/AdvisoryCommittees\/CommitteesMeetingMaterials\/Drugs\/AnestheticAndAnalgesicDrugProductsAdvisoryCommittee\/UCM522688.pdf. Accessed April 17 2018."},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.2844"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000324"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650701877374"},{"key":"e_1_2_10_45_1","unstructured":"FDA.Disposal of Unused Medicines: What You Should Know. 2018.https:\/\/www.fda.gov\/Drugs\/ResourcesForYou\/Consumers\/BuyingUsingMedicineSafely\/EnsuringSafeUseofMedicine\/SafeDisposalofMedicines\/ucm186187.htm. Accessed April 14 2018."},{"key":"e_1_2_10_46_1","unstructured":"Current Opioid Misuse Measure (COMM)\u2122. 2008.https:\/\/www.opioidprescribing.com\/documents\/09-comm-inflexxion.pdf. Accessed April 1 2018."},{"key":"e_1_2_10_47_1","unstructured":"Pain Assessment and Documentation Tool. 2003.http:\/\/www.practiceadvisor.org\/docs\/default-source\/documents\/pain_assessment_and_documentation_tool. Accessed April 1 2018."},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.10.009"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.07.008"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2011\/14\/123"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2007.0044"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12937"},{"issue":"1","key":"e_1_2_10_53_1","first-page":"CD003448","article-title":"Laxatives or methylnaltrexone for the management of constipation in palliative care patients","author":"Candy B","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.169"},{"key":"e_1_2_10_55_1","unstructured":"FDA requires strong warnings for opioid analgesics prescription opioid cough products and benzodiazepine labeling related to serious risks and death from combined use[press release]. Silver Spring MD: US Food and Drug Administration;2016."},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1604339"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2005.05031.x"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2006.00114.x"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2009.00671.x"},{"key":"e_1_2_10_60_1","unstructured":"Substance Use Screening & Assessment Instruments Database. 2017.http:\/\/lib.adai.washington.edu\/instruments\/. Accessed April 1 2018."},{"key":"e_1_2_10_61_1","unstructured":"American Society of Pain Medicine.Agreement on controlled substances therapy for chronic pain treatment.http:\/\/www.painmed.org\/library\/clinical-resources\/. Accessed April 1 2018."},{"key":"e_1_2_10_62_1","unstructured":"SAMHSA.SBIRT: screening brief intervention and referral to treatment.https:\/\/www.integration.samhsa.gov\/clinical-practice\/sbirt. Accessed April 1 2018."},{"key":"e_1_2_10_63_1","volume-title":"Screening, Brief Intervention and Referral to Treatment (SBIRT) in Behavioral Healthcare","year":"2011"},{"key":"e_1_2_10_64_1","unstructured":"Treatment Improvement Protocol (TIP) Series 2004 40 Clinical guidelines for the use of buprenorphine in the treatment of opioid addiction. Subjective Opiate Withdrawal Scale (SOWS)"},{"key":"e_1_2_10_65_1","unstructured":"Drug Safety Commun. 2017 FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants: careful medication management can reduce risks"},{"key":"e_1_2_10_66_1","article-title":". FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning","author":"FDA Drug Safety Communication","year":"2016","journal-title":"Drug Safety Commun."}],"container-title":["The Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjcph.1276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.1276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:29:37Z","timestamp":1694996977000},"score":1,"resource":{"primary":{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/10.1002\/jcph.1276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,9]]},"references-count":65,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1002\/jcph.1276"],"URL":"https:\/\/doi.org\/10.1002\/jcph.1276","archive":["Portico"],"relation":{},"ISSN":["0091-2700","1552-4604"],"issn-type":[{"value":"0091-2700","type":"print"},{"value":"1552-4604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,9]]},"assertion":[{"value":"2018-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}