Review  |   December 2019
Review of Opioid Prescribing in the Osteopathic and Ambulatory Setting
Author Notes
  • From the NeuroMusculoskeletal Institute at Rowan University School of Osteopathic Medicine in Stratford, New Jersey.  
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Richard T. Jermyn, DO, Rowan University School of Osteopathic Medicine NeuroMusculoskeletal Institute, 42 E Laurel Rd, Ste 1700, Stratford, NJ, 08084-1354. Email: jermynrt@rowan.edu
     
Article Information
Pain Management/Palliative Care / Opioids
Review   |   December 2019
Review of Opioid Prescribing in the Osteopathic and Ambulatory Setting
The Journal of the American Osteopathic Association, December 2019, Vol. 119, 820-832. doi:https://doi.org/10.7556/jaoa.2019.134
The Journal of the American Osteopathic Association, December 2019, Vol. 119, 820-832. doi:https://doi.org/10.7556/jaoa.2019.134
Abstract

The opioid epidemic in the United States is one of the largest modern health crises in the nation's history. The crisis has been cultivated in academic journals, driven by the medical-pharmaceutical complex, and fueled by campaigns representing the most prestigious health care organizations and advocacy groups. Comprehensive guidelines for proper prescribing have been released in addition to state-sponsored prescription drug–monitoring programs (PDMPs) in response to overprescribing habits. When considering opioid treatment for a patient, physicians should document a thorough history of pain, give an appropriate physical examination, and complete a risk assessment using the proper diagnostic tools. Considering the osteopathic philosophy and approach to chronic pain, physicians should account for an integrative treatment approach for improved patient outcomes when considering applying the osteopathic philosophy to chronic pain management. A successful treatment plan can integrate cognitive behavioral therapy and promote self-healing by treating somatic dysfunctions with osteopathic manipulative treatment. This literature review discusses how to treat patients with chronic pain and how to properly use and prescribe opioids. The researchers analyzed the history and current status of the opioid epidemic, examined opioid management in the outpatient setting, reviewed the current domestic and international opioid prescribing guidelines, and discussed the incorporation of the osteopathic philosophy to manage chronic pain.

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