5 responses to “Can we identify patients at risk for Opioid Use Disorder when beginning opioid analgesics for pain from new or ongoing non-cancer causes?”

  1. Thank you. I will use the disclaimer statements re: opioid risk while charting.

  2. I find opioid prescribing absolutely terrifying. Patients often come to our clinic already on regular high doses and sometimes also benzodiazepines. We still have to treat the severe chronic pain that they say they have and so just saying no isn’t an option . I tell them all about the risks and benefits and try alternatives but usually it ends up back at opioids. If physio was provided through MSP I think that would help.

  3. Very interesting. I believe that this needs to be brought to attention more. This is something that I widely see being an issue.

  4. Excellent and important article.

    I like to think of the opioid overdose crisis in two broad categories–(1) prevention vs (2) management of those with OUD–and I think confusion about the different responses needed from prescribers has caused and continues to cause significant harm:

    1. Those who are opioid-naive but at risk of OUD: the approach outlined in your article is very important

    2. Those with established OUD: we need the opposite approach of ensuring these people have access to a safe opioid supply (eg OAT, iOAT, other), working with patient preferences. Forcefully cutting-off or decreasing doses of Rx opioids to these folks can be very dangerous and harmful given the obvious alternative of a very unsafe illicit market.

  5. Cost is a factor as well. For patients without insurance, opioids are often significantly less expensive than the NSAIDs, Lyrica etc alternatives. Usually these same patients cannot afford physiotherapy, massage therapy etc

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