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Wood, Evan
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Wood, Evan
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Wood, Evan
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- PublicationDiagnosing opioid addiction in people with chronic painOver the past two decades, a steep rise in the number of opioids dispensed for pain treatment has been accompanied by a dramatic rise in overdose deaths in the United States. In 2016, up to 32 000 deaths reportedly involved prescription opioids, and the economic burden of prescription opioid overdose has been estimated to exceed $78bn (£59bn; €67bn) annually. Despite all the evidence of harm, however, it remains unclear exactly how to determine if a patient with chronic pain has opioid addiction, or what criteria should serve as a gold standard in making a diagnosis of opioid use disorder (OUD) in this context. This is an important gap in the literature that hinders both evidence-based care and research on the links between prescription opioids and OUD. In this editorial, we discuss the limitations of diagnosing OUD in people with chronic pain, and make several recommendations for further research.
755Scopus© Citations 15 - PublicationPrescription opioids, opioid use disorder, and overdose crisis in Canada: Current dilemmas and remaining questionsIn Canada, a rise in opioid use disorder (OUD) and overdose has been linked to opioid prescriptions in a number of contexts. At the same time, relatively few patients prescribed opioids reportedly develop OUD. This combination of findings suggests a pressing need for research on specific avenues through which medically prescribed opioids influence OUD and overdose in Canada. In this commentary, we therefore discuss a few of the potential processes that might allow for medically prescribed opioids to indirectly influence rising overdose rates, and the processes that might account for inconsistencies between large correlational research and studies of OUD incidence in opioid prescribed patients.
366Scopus© Citations 2 - PublicationA Case of Opioid Overdose and Subsequent Death After Medically Supervised Withdrawal: The Problematic Role of Rapid Tapers for Opioid Use DisorderBACKGROUND: Relapse to opioid use is common after rapid opioid withdrawal. As a result, short-term tapers of opioid agonist/partial agonist medications, such as methadone and buprenorphine/naloxone, are no longer recommended by recent clinical care guidelines for the management of opioid use disorder. Nonetheless, rapid tapers are still commonplace in medically supervised withdrawal settings.CASE SUMMARY: We report a case of an individual with opioid use disorder who was prescribed a rapid buprenorphine/naloxone taper in a medically supervised withdrawal facility and who had a subsequent opioid overdose and death after discharge. DISCUSSION:The fatal outcome in this case study underscores the potential severe harms associated with use of rapid tapers. Given the increased overdose risk, tapers should be avoided and continuing care strategies, such as maintenance pharmacotherapy, should be initiated in medically supervised withdrawal settings.
192Scopus© Citations 12