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Tackling the Difficult Problem of Prescription Opioid Misuse

Howard A. Heit, MD; and Douglas L. Gourlay, MD, MSc
[+] Article, Author, and Disclosure Information

From Georgetown School of Medicine, Fairfax, VA 22031, and Mount Sinai Hospital, Toronto, Ontario M5G 1X5, Canada.

Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-0858.

Corresponding Author: Howard A. Heit, MD, Georgetown School of Medicine, Department of Medicine, 8316 Arlington Boulevard, Suite 232, Fairfax, VA 22031; e-mail, howard204@aol.com.

Current Author Addresses: Dr. Heit: Georgetown School of Medicine, Department of Medicine, 8316 Arlington Boulevard, Suite 232, Fairfax, VA 22031.

Dr. Gourlay: Wasser Pain Management Centre, Department of Anesthesiology and Psychiatry, Room 1160, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.

Ann Intern Med. 2010;152(11):747-748. doi:10.7326/0003-4819-152-11-201006010-00013
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Stories about the tragic consequences of prescription drug misuse increasingly populate the media. In 2007, the Substance Abuse and Mental Health Services Administration revealed that in the previous year, illicit use of prescription opioids exceeded that of marijuana among persons 12 years or older (1). Clearly, times are changing, and abuse of prescription drugs is something clinicians must actively address. In this issue, Starrels and colleagues (2) report a review of the evidence about the effectiveness of 2 common clinical tools to reduce opioid misuse in patients with chronic pain: opioid treatment agreements and urine drug testing. We commend the authors' efforts to better understand the difficult, growing, and too often ignored challenge of prescription drug misuse. Unfortunately, this review documents how much more we need to know to successfully tackle this vexing issue.


opioid abuse

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