{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:41:50Z","timestamp":1788406910621,"version":"build-2803163510"},"reference-count":24,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T00:00:00Z","timestamp":1438387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2015,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\u201cChemical coping\u201d is a commonly used term in the pain and palliative care literature, but is heterogeneously defined. We conducted a Delphi survey among palliative care and pain specialists internationally to identify a consensus definition for \u201cchemical coping with opioids\u201d and warning signs for chemical coping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This Delphi survey consisted of two rounds on the following: (1) concepts and definition related to chemical coping, (2) warning signs for chemical coping, and (3) demographics. Consensus in this study was defined as agreement by a minimum of 70% of the experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Participating in the first round were 14\/19 (74%) physicians; 12\/14 (86%) participated in the second round. The international experts reached the following consensus definition for chemical coping with opioids (92% agreement): \u201cThe use of opioids to cope with emotional distress, characterized by inappropriate and\/or excessive opioid use.\u201d They also identified depression (consensus 93%); psychiatric disease (86%); a history of substance abuse (86%); a positive score for the Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) alcoholism screening test (79%); a history of alcoholism (79%); and a history of smoking (71%) as important warning signs for chemical coping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our expert panel reached a consensus definition for chemical coping and related warning signs, which may help clinicians and researchers to identify patients at risk of opioid misuse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2014.0446","type":"journal-article","created":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T12:40:10Z","timestamp":1430311210000},"page":"703-706","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":41,"title":["A Pilot Study To Define Chemical Coping in Cancer Patients Using the Delphi Method"],"prefix":"10.1177","volume":"18","author":[{"given":"Jung Hye","family":"Kwon","sequence":"first","affiliation":[{"name":"University of Texas MD Anderson Cancer Center"},{"name":"Hallym University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hui","sequence":"additional","affiliation":[{"name":"University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[{"name":"University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,8,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70040-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(95)00084-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2012.0113"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951507000387"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2012.684621"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.5170"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.02.021"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.04.016"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-010-0118-6"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2009.110"},{"key":"e_1_3_3_12_2","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2000","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. 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