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Epi Seminar Series

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Tuesday, June 5, 2012

"Long-term Opioid Therapy for Chronic Pain: Risks and Risk Mitigation"
3:30 pm to 4:50 pm
Health Sciences K-069

Dr Korff

 


Michael Von Korff, Sc.D.

Senior Investigator at the Group Health Research Institute, Group Health Cooperative

Abstract:

Over the past 20 years, use of long-term opioid therapy for chronic non-cancer pain increased markedly in the absence of adequate evidence regarding benefits or risks. Randomized trials of use of opioids for chronic pain have been too small and too brief to evaluate safety outcomes. Increased opioid prescribing for chronic non-cancer pain has been fueled by pharmaceutical industry educational initiatives targeting primary care physicians, using professional societies, patient advocacy organizations and pain specialists to influence opioid prescribing. With increased opioid prescribing, problems with opioid diversion, overdose and addiction were identified by federal surveillance systems, including a marked increase in fatal drug overdose involving prescription opioids. Subsequently, pharmacoepidemiologic studies identified dose-related risks of overdose and other adverse events. In the absence of data from large controlled trials, whether opioids are over-prescribed or under-prescribed remains controversial. In 2011, the White House Office of National Drug Control Policy, the DEA and the FDA announced an action plan to stem an epidemic of prescription drug abuse and overdose. Data on Group Health research and chronic opioid therapy risk mitigation initiatives will be presented relevant to potential strategies for reducing risks without undue restrictions on prescribing practices.

Suggested Reading:

  • Long Term Opioid Therapy Reconsidered
    Michael Von Korff, ScD; Andrew Kolodny, MD; Richard A. Deyo, MD, MPH;Rroger Chou, MD

  • Opioid Prescriptions for Chronic Pain and Overdose
    Kate M. Dunn, PhD; Kathleen W. Saunders, JD; Carolyn M. Rutter, PhD; Caleb J. Banta-Gree, MSW, MPH, PhD; Joseph O Merrill, MD, MPH; Mark D. Sullivan, MD, PhD; Constance M. Weisner, DrPh, MSW; Michael J. Silverberg, PhD, MPH; Cynthia I. Campbell, PhD; Bruce M. Psaty, MD, PhD; and Michael Von Korff, ScD

Bio:

Dr. Von Korff is a Senior Investigator at the Group Health Research Institute, Group Health Cooperative.  His research concerns management and outcomes of chronic pain, depression and other common chronic conditions among primary care patients.  He has led work on large randomized controlled trials of health care innovations, including collaborative care programs for depressive illness and self-management programs for chronic-recurrent back pain.  His current research concerns use of opioid medications for chronic pain and associated health effects, prognostic models for chronic pain,  evaluation of collaborative care models for care of complex chronic disease patients with comorbid depressive illness, and evaluation of an integrated intervention for chronic pain and insomnia among persons with osteoarthritis. 

Updated on March 28, 2012