TY - JOUR KW - Analgesics, Opioid/therapeutic use/urine KW - Humans KW - Opioid-Related Disorders/diagnosis/prevention & control KW - Pain/drug therapy KW - Primary Health Care/methods KW - Referral and Consultation KW - Risk Factors KW - Substance Abuse Detection AU - B. H. McCarberg A1 - AB - Pain is among the most common reasons patients seek medical attention, and the care of patients with pain is a significant problem in the United States. Acute pain (mild-to-moderate intensity) represents one of the most frequent complaints encountered by primary care physicians (PCPs) and accounts for nearly half of patient visits. However, the overall quality of pain management remains unacceptable for millions of US patients with acute or chronic pain, and underrecognition and undertreatment of pain are of particular concern in primary care. Primary care physicians face dual challenges from the emerging epidemics of undertreated pain and prescription opioid abuse. Negative impacts of untreated pain on patient activities of daily living and public health expenditures, combined with the success of opioid analgesics in treating pain provide a strong rationale for PCPs to learn best practices for pain management. These clinicians must address the challenge of maintaining therapeutic access for patients with a legitimate medical need for opioids, while simultaneously minimizing the risk of abuse and addiction. Safe and effective pain management requires clinical skill and knowledge of the principles of opioid treatment as well as the effective assessment of risks associated with opioid abuse, addiction, and diversion. Easily implementable patient selection and screening, with selective use of safeguards, can mitigate potential risks of opioids in the busy primary practice setting. Primary care physicians can become advocates for proper pain management and ensure that all patients with pain are treated appropriately. BT - Postgraduate medicine C5 - Opioids & Substance Use; Education & Workforce CP - 2 CY - England DO - 10.3810/pgm.2011.03.2270 IS - 2 JF - Postgraduate medicine N2 - Pain is among the most common reasons patients seek medical attention, and the care of patients with pain is a significant problem in the United States. Acute pain (mild-to-moderate intensity) represents one of the most frequent complaints encountered by primary care physicians (PCPs) and accounts for nearly half of patient visits. However, the overall quality of pain management remains unacceptable for millions of US patients with acute or chronic pain, and underrecognition and undertreatment of pain are of particular concern in primary care. Primary care physicians face dual challenges from the emerging epidemics of undertreated pain and prescription opioid abuse. Negative impacts of untreated pain on patient activities of daily living and public health expenditures, combined with the success of opioid analgesics in treating pain provide a strong rationale for PCPs to learn best practices for pain management. These clinicians must address the challenge of maintaining therapeutic access for patients with a legitimate medical need for opioids, while simultaneously minimizing the risk of abuse and addiction. Safe and effective pain management requires clinical skill and knowledge of the principles of opioid treatment as well as the effective assessment of risks associated with opioid abuse, addiction, and diversion. Easily implementable patient selection and screening, with selective use of safeguards, can mitigate potential risks of opioids in the busy primary practice setting. Primary care physicians can become advocates for proper pain management and ensure that all patients with pain are treated appropriately. PP - England PY - 2011 SN - 1941-9260; 0032-5481 SP - 119 EP - 130 EP - T1 - Pain management in primary care: strategies to mitigate opioid misuse, abuse, and diversion T2 - Postgraduate medicine TI - Pain management in primary care: strategies to mitigate opioid misuse, abuse, and diversion U1 - Opioids & Substance Use; Education & Workforce U2 - 21474900 U3 - 10.3810/pgm.2011.03.2270 VL - 123 VO - 1941-9260; 0032-5481 Y1 - 2011 ER -