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Opioid therapy: managing risks of abuse, addiction, and diversion 

Opioid therapy: managing risks of abuse, addiction, and diversion
Opioid therapy: managing risks of abuse, addiction, and diversion

Julie R. Price

, Alric D. Hawkins

, and Steven D. Passik

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date: 24 January 2022

Given the complex and chronic medical problems that are seen in the palliative care setting, there is an ever increasing need for awareness of prescription drug abuse. Providers must balance the potential for abuse of prescribed opioids with the need to provide appropriate analgesia for patients in the palliative care setting. In addition, the presence of aberrant drug use amongst patients with advanced illness represents a major impediment to appropriate care. In order to maximize patient outcomes and to prescribe needed medication both safely and fairly, the clinician should work to develop appropriate controls and monitoring. Aberrant drug-related behaviour is a complex phenomenon that can occur in the chronic medically ill patient and needs to be approached in an empathetic manner that allows for recognition of the biological, chemical, psychological, and social aspects, with the ultimate goal of safely managing patients’ pain, while addressing other issues that are leading to their distress and perpetuating their aberrant drug use.

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