The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Prevention, diagnosis, and treatment of opioid use disorder under the supervision of opioid stewardship programs: it's time to act now

  • Kim, Eun-Ji (Department of Pharmacy, Pusan National University Yangsan Hospital) ;
  • Hwang, Eun-Jung (Department of Pharmacy, Pusan National University Yangsan Hospital) ;
  • Yoo, Yeong-Min (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Kim, Kyung-Hoon (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University)
  • Received : 2022.07.23
  • Accepted : 2022.09.15
  • Published : 2022.10.01
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Abstract

The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α2 agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.

Keywords

Acknowledgement

This study was supported by a 2-year (from 2021 to 2023) research grant from Pusan National University.

References

  1. Shapiro JL. The third opium war?: understanding China through history. Horizons 2019; 13: 52-65.
  2. Jayawardana S, Forman R, Johnston-Webber C, Campbell A, Berterame S, de Joncheere C, et al. Global consump- tion of prescription opioid analgesics between 2009-2019: a country-level observational study. EClinicalMedicine 2021; 42: 101198. https://doi.org/10.1016/j.eclinm.2021.101198
  3. Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths--United States, 2000-2014. MMWR Morb Mortal Wkly Rep 2016; 64: 1378-82. https://doi.org/10.15585/mmwr.mm6450a3
  4. Soffin EM, Lee BH, Kumar KK, Wu CL. The prescription opioid crisis: role of the anaesthesiologist in reducing opioid use and misuse. Br J Anaesth 2019; 122: e198-208. https://doi.org/10.1016/j.bja.2018.11.019
  5. Yang J, Bauer BA, Wahner-Roedler DL, Chon TY, Xiao L. The modified WHO analgesic ladder: is it appropriate for chronic non-cancer pain? J Pain Res 2020; 13: 411-7. https://doi.org/10.2147/jpr.s244173
  6. Woolf CJ. Capturing novel non-opioid pain targets. Biol Psychiatry 2020; 87: 74-81. https://doi.org/10.1016/j.biopsych.2019.06.017
  7. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin 2021; 71: 7-33. Erratum in: CA Cancer J Clin 2021; 71: 359. https://doi.org/10.3322/caac.21669
  8. Collett BJ. Chronic opioid therapy for non-cancer pain. Br J Anaesth 2001; 87: 133-43. https://doi.org/10.1093/bja/87.1.133
  9. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Sub-committee on Taxonomy. Pain Suppl 1986; 3: S1-226.
  10. Uritsky TJ, Busch ME, Chae SG, Genord C. Opioid steward-ship: building on antibiotic stewardship principles. J Pain Palliat Care Pharmacother 2020; 34: 181-3. https://doi.org/10.1080/15360288.2020.1765066
  11. Centers for Disease Control and Prevention (CDC). Core elements of hospital antibiotic stewardship programs [Internet]. Atlanta (GA): CDC; 2019. Available at: https://www.cdc.gov/antibiotic-use/healthcare/pdfs/hospital-core-elements-H.pdf.
  12. Institute for Safe Medication Practices (ISMP) Canada. Opioid stewardship [Internet]. Toronto (ON): ISMP Cana-da; 2017. Available at: https://www.ismp-canada.org/opi-oid_stewardship/.
  13. Dowell D, Haegerich TM, Chou R. CDC guideline for pre-scribing opioids for chronic pain--United States, 2016. JAMA 2016; 315: 1624-45. https://doi.org/10.1001/jama.2016.1464
  14. National Quality Forum (NQF). National Quality Partners Playbook TM : opioid stewardship. Washington, D.C., NQF. 2018.
  15. American Hospital Association (AHA). Stem the tide: opioid stewardship measurement implementation guide [Internet]. Chicago (IL): AHA; 2020. https://www.aha.org/system/files/media/file/2020/07/HIIN-opioid-guide-0520.pdf.
  16. Trescot AM, Datta S, Lee M, Hansen H. Opioid pharmacology. Pain Physician 2008; 11(2 Suppl): S133-53. https://doi.org/10.36076/ppj.2008/11/S133
  17. World Health Organization (WHO). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva, WHO Press. 2009, p 5.
  18. World Health Organization (WHO). ICD-10. International statistical classification of diseases and related health problems. 10th ed. Geneva, WHO Press. 2016, pp 289-92.
  19. World Health Organization (WHO). International Classification of Diseases 11th edition: the global standard for diagnostic health information [Internet]. Geneva: WHO; 2022. Available at: https://icd.who.int/browse11/l-m/en#/ http://id.who.int/icd/entity/1023217081.
  20. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, D.C., American Psychiatric Association Publishing. 2013, pp 1-947.
  21. Brady KT, McCauley JL, Back SE. Prescription opioid misuse, abuse, and treatment in the United States: an update. Am J Psychiatry 2016; 173: 18-26. https://doi.org/10.1176/appi.ajp.2015.15020262
  22. Volkow ND, McLellan AT. Opioid abuse in chronic pain-misconceptions and mitigation strategies. N Engl J Med 2016; 374: 1253-63. https://doi.org/10.1056/NEJMra1507771
  23. Ballantyne JC, LaForge SK. Opioid dependence and addiction during opioid treatment of chronic pain. Pain 2007; 129: 235-55. Erratum in: Pain 2007; 131: 350.
  24. Srivastava AB, Mariani JJ, Levin FR. New directions in the treatment of opioid withdrawal. Lancet 2020; 395: 1938-48. https://doi.org/10.1016/s0140-6736(20)30852-7
  25. Kosten TR, Baxter LE. Review article: effective management of opioid withdrawal symptoms: a gateway to opioid dependence treatment. Am J Addict 2019; 28: 55-62. https://doi.org/10.1111/ajad.12862
  26. Inciardi JA, Surratt HL, Lugo Y, Cicero TJ. The diversion of prescription opioid analgesics. Law Enforc Exec Forum 2007; 7: 127-41.
  27. Iwanicki JL, Severtson SG, McDaniel H, Rosenblum A, Fong C, Cicero TJ, et al. Abuse and diversion of immediate release opioid analgesics as compared to extended release formulations in the United States. PLoS One 2016; 11: e0167499. https://doi.org/10.1371/journal.pone.0167499
  28. Berge KH, Dillon KR, Sikkink KM, Taylor TK, Lanier WL. Diversion of drugs within health care facilities, a multiplevictim crime: patterns of diversion, scope, consequences, detection, and prevention. Mayo Clin Proc 2012; 87: 674-82. https://doi.org/10.1016/j.mayocp.2012.03.013
  29. Perry JC, Vandenhouten CL. Drug diversion detection. Nurs Manage 2019; 50: 16-21. https://doi.org/10.1097/01.NUMA.0000552735.56577.4b
  30. O'Brien T, Christrup LL, Drewes AM, Fallon MT, Kress HG, McQuay HJ, et al. European Pain Federation position paper on appropriate opioid use in chronic pain management. Eur J Pain 2017; 21: 3-19. https://doi.org/10.1002/ejp.970
  31. Nafziger AN, Barkin RL. Opioid therapy in acute and chronic pain. J Clin Pharmacol 2018; 58: 1111-22. https://doi.org/10.1002/jcph.1276
  32. Gustorff B, Nahlik G, Hoerauf KH, Kress HG. The absence of acute tolerance during remifentanil infusion in volunteers. Anesth Analg 2002; 94: 1223-8. https://doi.org/10.1097/00000539-200205000-00032
  33. Cortinez LI, Brandes V, Munoz HR, Guerrero ME, Mur M. No clinical evidence of acute opioid tolerance after remifentanil-based anaesthesia. Br J Anaesth 2001; 87: 866-9. https://doi.org/10.1093/bja/87.6.866
  34. Guignard B, Bossard AE, Coste C, Sessler DI, Lebrault C, Alfonsi P, et al. Acute opioid tolerance: intraoperative remifentanil increases postoperative pain and morphine requirement. Anesthesiology 2000; 93: 409-17. https://doi.org/10.1097/00000542-200008000-00019
  35. Yu EH, Tran DH, Lam SW, Irwin MG. Remifentanil tolerance and hyperalgesia: short-term gain, long-term pain? Anaesthesia 2016; 71: 1347-62. https://doi.org/10.1111/anae.13602
  36. Ilkjaer S, Petersen KL, Brennum J, Wernberg M, Dahl JB. Effect of systemic N-methyl-D-aspartate receptor antago- nist (ketamine) on primary and secondary hyperalgesia in humans. Br J Anaesth 1996; 76: 829-34. https://doi.org/10.1093/bja/76.6.829
  37. Felsby S, Nielsen J, Arendt-Nielsen L, Jensen TS. NMDA receptor blockade in chronic neuropathic pain: a comparison of ketamine and magnesium chloride. Pain 1996; 64: 283-91. https://doi.org/10.1016/0304-3959(95)00113-1
  38. Ramasubbu C, Gupta A. Pharmacological treatment of opioid-induced hyperalgesia: a review of the evidence. J Pain Palliat Care Pharmacother 2011; 25: 219-30. https://doi.org/10.3109/15360288.2011.589490
  39. Kim KH. Safe sedation and hypnosis using dexmedetomidine for minimally invasive spine surgery in a prone position. Korean J Pain 2014; 27: 313-20. https://doi.org/10.3344/kjp.2014.27.4.313
  40. Zhao Y, He J, Yu N, Jia C, Wang S. Mechanisms of dexmedetomidine in neuropathic pain. Front Neurosci 2020; 14: 330. https://doi.org/10.3389/fnins.2020.00330
  41. Grape S, Kirkham KR, Frauenknecht J, Albrecht E. Intraoperative analgesia with remifentanil vs. dexmedetomidine: a systematic review and meta-analysis with trial sequential analysis. Anaesthesia 2019; 74: 793-800. https://doi.org/10.1111/anae.14657
  42. Kim KH, Seo HJ, Abdi S, Huh B. All about pain pharmacology: what pain physicians should know. Korean J Pain 2020; 33: 108-20. https://doi.org/10.3344/kjp.2020.33.2.108
  43. Conrad KA, Fagan TC, Mackie MJ, Mayshar PV. Effects of ketorolac tromethamine on hemostasis in volunteers. Clin Pharmacol Ther 1988; 43: 542-6. https://doi.org/10.1038/clpt.1988.70
  44. Shrestha M, Chen A. Modalities in managing postherpetic neuralgia. Korean J Pain 2018; 31: 235-43. https://doi.org/10.3344/kjp.2018.31.4.235
  45. Raja SN, Haythornthwaite JA, Pappagallo M, Clark MR, Travison TG, Sabeen S, et al. Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebocontrolled trial. Neurology 2002; 59: 1015-21. https://doi.org/10.1212/WNL.59.7.1015
  46. Adejumo AC, Akanbi O, Alayo Q, Ejigah V, Onyeakusi NE, Omede OF, et al. Predictors, rates, and trends of opioid use disorder among patients hospitalized with chronic pancreatitis. Ann Gastroenterol 2021; 34: 262-72.
  47. Toskes PP. Alcohol consumption and chronic pancreatitis. Mayo Clin Proc 2001; 76: 241. https://doi.org/10.4065/76.3.241
  48. Berna C, Kulich RJ, Rathmell JP. Tapering long-term opioid therapy in chronic noncancer pain: evidence and recommendations for everyday practice. Mayo Clin Proc 2015; 90: 828-42. https://doi.org/10.1016/j.mayocp.2015.04.003
  49. Palmer G. Complex regional pain syndrome. Aust Prescr 2015; 38: 82-6. https://doi.org/10.18773/austprescr.2015.029
  50. Donegan D, Bancos I. Opioid-induced adrenal insufficiency. Mayo Clin Proc 2018; 93: 937-44. https://doi.org/10.1016/j.mayocp.2018.04.010
  51. Lee SJ, Yoo YM, You JA, Shin SW, Kim TK, Abdi S, et al. Successful removal of permanent spinal cord stimulators in patients with complex regional pain syndrome after complete relief of pain. Korean J Pain 2019; 32: 47-50. https://doi.org/10.3344/kjp.2019.32.1.47
  52. Koulousakis A, Kuchta J, Bayarassou A, Sturm V. Intrathecal opioids for intractable pain syndromes. Acta Neurochir Suppl 2007; 97(Pt 1): 43-8.
  53. Kim WS, Kim KH. Percutaneous osteoplasty for painful bony lesions: a technical survey. Korean J Pain 2021; 34: 375-93. https://doi.org/10.3344/kjp.2021.34.4.375
  54. Lipton A, Uzzo R, Amato RJ, Ellis GK, Hakimian B, Roodman GD, et al. The science and practice of bone health in oncology: managing bone loss and metastasis in patients with solid tumors. J Natl Compr Canc Netw 2009; 7(Suppl 7): S1-29.
  55. Yang S, Park DH, Ahn SH, Kim J, Lee JW, Han JY, et al. Prevalence and risk factors of adhesive capsulitis of the shoulder after breast cancer treatment. Support Care Cancer 2017; 25: 1317-22. https://doi.org/10.1007/s00520-016-3532-4
  56. Del Fabbro E. Assessment and management of chemical coping in patients with cancer. J Clin Oncol 2014; 32: 1734-8. https://doi.org/10.1200/JCO.2013.52.5170
  57. Pergolizzi JV Jr, Magnusson P, Christo PJ, LeQuang JA, Breve F, Mitchell K, et al. Opioid therapy in cancer patients and survivors at risk of addiction, misuse or complex dependency. Front Pain Res (Lausanne) 2021; 2: 691720. https://doi.org/10.3389/fpain.2021.691720
  58. Goodlev ER, Discala S, Darnall BD, Hanson M, Petok A, Silverman M. Managing cancer pain, monitoring for cancer recurrence, and mitigating risk of opioid use disorders: a team-based, interdisciplinary approach to cancer survivorship. J Palliat Med 2019; 22: 1308-17. https://doi.org/10.1089/jpm.2019.0171
  59. Trescot AM, Helm S, Hansen H, Benyamin R, Glaser SE, Adlaka R, et al. Opioids in the management of chronic non-cancer pain: an update of American Society of the Interventional Pain Physicians' (ASIPP) Guidelines. Pain Physician 2008; 11(2 Suppl): S5-62.
  60. Drug Enforcement Administration, U.S. Department of Justice. Drugs of abuse. A DEA resource guide: 2020 ed. [Internet]. Springfield (VA): DEA; 2020. Available at: https://www.dea.gov/sites/default/files/2020-04/Drugs%of%Abuse%2020-Web%Version-508%compliant-4-24-20_0.pdf.
  61. Pagel JF, Parnes BL. Medications for the treatment of sleep disorders: an overview. Prim Care Companion J Clin Psychiatry 2001; 3: 118-25.
  62. Busse JW, Craigie S, Juurlink DN, Buckley DN, Wang L, Couban RJ, et al. Guideline for opioid therapy and chronic noncancer pain. CMAJ 2017; 189: E659-66. https://doi.org/10.1503/cmaj.170363
  63. Barker C, Taylor A, Johnson M. Problematic pain - redefining how we view pain? Br J Pain 2014; 8: 9-15. https://doi.org/10.1177/2049463713512618
  64. Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P, et al.; American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 2009; 10: 113-30. https://doi.org/10.1016/j.jpain.2008.10.008
  65. The ASAM national practice guideline for the treatment of opioid use disorder: 2020 focused update. J Addict Med 2020; 14(2S Suppl 1): 1-91. Erratum in: J Addict Med 2020 14: 267.
  66. Crotty K, Freedman KI, Kampman KM. Executive summary of the focused update of the ASAM national practice guideline for the treatment of opioid use disorder. J Addict Med 2020; 14: 99-112. Erratum in: J Addict Med 2020; 14: 267.
  67. U.S. Food and Drug Administration. FDA Drug Safety Communications: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning [Internet]. Silver Spring (MD): U.S. Food and Drug Ad-ministration; 2016. Available at: http://www.fda.gov/me-dia/99761/download.
  68. National Institute on Drug Abuse (NIDA). Medications to treat opioid use disorder research report: how much does opioid treatment cost? [Internet]. Gaithersburg (MD): NIDA; 2016. Available at: https://nida.nih.gov/publica-tions/research-reports/medications-to-treat-opioid-addiction/how-much-does-opioid-treatment-cost.
  69. Substance Abuse and Mental Health Services Administration (SAMHSA). Federal guidelines for opioid treatment programs [Internet]. Rockville (MD): SAMHSA; 2015. Available at: https://store.samhsa.gov/sites/default/files/d7/priv/pep15-fedguideotp.pdf.
  70. Johnson RE, Chutuape MA, Strain EC, Walsh SL, Stitzer ML, Bigelow GE. A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence. N Engl J Med 2000; 343: 1290-7. https://doi.org/10.1056/NEJM200011023431802
  71. Cheattle MD. Risk assessment: safe opioid prescribing tools [Internet]. New York (NY): Practical Pain Manage-ment; 2019. Available at: https://www.practicalpainman-agement.com/resource-centers/opioid-prescribing-moni-toring/risk-assessment-safe-opioid-prescribing-tools.
  72. Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med 2005; 6: 432-42. https://doi.org/10.1111/j.1526-4637.2005.00072.x
  73. Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN. Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R). J Pain 2008; 9: 360-72. https://doi.org/10.1016/j.jpain.2007.11.014
  74. Coambs RE, Jarry JL, Santhiapillai AC, Abrahamsohn RV, Atance CM. The SISAP: a new screening instrument for identifying potential opioid abusers in the management of chronic nonmalignant pain within general medical practice. Pain Res Manag 1996; 1: 155-62. https://doi.org/10.1155/1996/391248
  75. Belgrade MJ, Schamber CD, Lindgren BR. The DIRE score: predicting outcomes of opioid prescribing for chronic pain. J Pain 2006; 7: 671-81. https://doi.org/10.1016/j.jpain.2006.03.001
  76. Compton PA, Wu SM, Schieffer B, Pham Q, Naliboff BD. Introduction of a self-report version of the Prescription Drug Use Questionnaire and relationship to medication agreement noncompliance. J Pain Symptom Manage 2008; 36: 383-95. https://doi.org/10.1016/j.jpainsymman.2007.11.006
  77. Butler SF, Budman SH, Fernandez KC, Houle B, Benoit C, Katz N, et al. Development and validation of the Current Opioid Misuse Measure. Pain 2007; 130: 144-56. Erratum in: Pain 2009; 142: 169.
  78. Adams LL, Gatchel RJ, Robinson RC, Polatin P, Gajraj N, Deschner M, et al. Development of a self-report screening instrument for assessing potential opioid medication misuse in chronic pain patients. J Pain Symptom Manage 2004; 27: 440-59. https://doi.org/10.1016/j.jpainsymman.2003.10.009
  79. Compton P, Darakjian J, Miotto K. Screening for addiction in patients with chronic pain and "problematic" substance use: evaluation of a pilot assessment tool. J Pain Symptom Manage 1998; 16: 355-63. https://doi.org/10.1016/S0885-3924(98)00110-9
  80. Passik SD, Kirsh KL, Whitcomb L, Schein JR, Kaplan MA, Dodd SL, et al. Monitoring outcomes during long-term opioid therapy for noncancer pain: results with the Pain Assessment and Documentation Tool. J Opioid Manag 2005; 1: 257-66. https://doi.org/10.5055/jom.2005.0055
  81. Wu SM, Compton P, Bolus R, Schieffer B, Pham Q, Baria A, et al. The addiction behaviors checklist: validation of a new clinician-based measure of inappropriate opioid use in chronic pain. J Pain Symptom Manage 2006; 32: 342-51. https://doi.org/10.1016/j.jpainsymman.2006.05.010
  82. Brown RL, Rounds LA. Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wis Med J 1995; 94: 135-40.
  83. Substance Abuse and Mental Health Services Administra- tion (SAMHSA). Screening, brief intervention, and referral to treatment (SBIRT) [Internet]. Rockville (MD): SAMHSA; 2022. Available at: http://www.samhsa.gov/sbirt.
  84. Bastiaens L, Riccardi K, Sakhrani D. The RAFFT as a screening tool for adult substance use disorders. Am J Drug Alcohol Abuse 2002; 28: 681-91. https://doi.org/10.1081/ADA-120015876
  85. Skinner HA. The drug abuse screening test. Addict Behav 1982; 7: 363-71. https://doi.org/10.1016/0306-4603(82)90005-3
  86. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT- C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med 1998; 158: 1789-95. https://doi.org/10.1001/archinte.158.16.1789
  87. Berman AH, Palmstierna T, Kallmen H, Bergman H. The self-report Drug Use Disorders Identification Test: Extended (DUDIT-E): reliability, validity, and motivational index. J Subst Abuse Treat 2007; 32: 357-69. https://doi.org/10.1016/j.jsat.2006.10.001
  88. Wakeman SE. Diagnosis and treatment of opioid use disorder in 2020. JAMA 2020; 323: 2082-3. https://doi.org/10.1001/jama.2020.4104
  89. U.S. Food and Drug Administration. Information about medication-assisted treatment (MAT) [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2019. Available at: https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat.
  90. Sordo L, Barrio G, Bravo MJ, Indave BI, Degenhardt L, Wi-essing L, et al. Mortality risk during and after opioid sub-stitution treatment: systematic review and meta-analysis of cohort studies. BMJ 2017; 357: j1550.
  91. Whelan PJ, Remski K. Buprenorphine vs methadone treatment: a review of evidence in both developed and developing worlds. J Neurosci Rural Pract 2012; 3: 45-50. https://doi.org/10.4103/0976-3147.91934
  92. Oakley B, Wilson H, Hayes V, Lintzeris N. Managing opioid withdrawal precipitated by buprenorphine with buprenorphine. Drug Alcohol Rev 2021; 40: 567-71. https://doi.org/10.1111/dar.13228
  93. Connery HS. Medication-assisted treatment of opioid use disorder: review of the evidence and future directions. Harv Rev Psychiatry 2015; 23: 63-75. https://doi.org/10.1097/HRP.0000000000000075
  94. Patterson Silver Wolf DA, Gold M. Treatment resistant opioid use disorder (TROUD): definition, rationale, and recommendations. J Neurol Sci 2020; 411: 116718. https://doi.org/10.1016/j.jns.2020.116718
  95. Substance Abuse and Mental Health Services Administration (SAMHSA). Protracted withdrawal. Substance abuse treatment advisory. News for the treatment field. 2010; 9: 1-8. U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration (SAMHSA). HHS Publication No. (SMA) 10-4554 [Internet]. Rockville (MD): SAMHSA; 2010. Available at: https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf.
  96. Nicholson SC, Peterson J, Yektashenas B. Risk evaluation and mitigation strategies (REMS): educating the prescriber. Drug Saf 2012; 35: 91-104. https://doi.org/10.2165/11597840-000000000-00000
  97. Korea Institute of Drug Safety and Risk Management. Introduction of DUR [Internet]. Anyang: Korea Institute of Drug Safety and Risk Management; 2012. Available at: https://www.drugsafe.or.kr/iwt/ds/en/useinfo/EgovIn-troductionDur.do;jsessionid=53QMnC26k99DG3u2FY638AOG8BogWIuUVYkBEqwtKqklSoVgUOBjwLqbWlZlxoH4.webint_2_servlet_engine1.
  98. Korea Institute of Drug Safety and Risk Management. Introduction of narcotics handling report system (NHRS) [Internet]. Anyang: Korea Institute of Drug Safety and Risk Management; 2015. Available at: https://www.drugsafe. or.kr/iwt/ds/en/introduction/HandlingReporting.do;jses-sionid=ZNaCx119JkUJTu1c62TzYUJudPH4D1aeUucLyaaU6cjG1geHyEWfRC0yuF0lD171.webint_2_servlet_engine1.
  99. Health Insurance Review and Assessment Service. Drug utilization review (DUR) [Internet]. Wonju: Health Insurance Review and Assessment Service; 2020. Available at: https://www.hira.or.kr/eng/about/05/01/04/index.html.
  100. Baldini A, Von Korff M, Lin EH. A review of potential adverse effects of long-term opioid therapy: a practitioner's guide. Prim Care Companion CNS Disord 2012; 14: PCC.11m01326.
  101. Petzke F, Bock F, Huppe M, Nothacker M, Norda H, Radbruch L, et al. Long-term opioid therapy for chronic noncancer pain: second update of the German guidelines. Pain Rep 2020; 5: e840. https://doi.org/10.1097/PR9.0000000000000840
  102. Ford C, Barnard J, Bury J, Carnwath T, Gerada C, Joyce A, et al. Royal College of General Practitioners: guidance for the use of methadone for the treatment of opioid dependence in primary care [Internet]. London: Royal College of General Practitioners; 2005. Available at: https://www.drugsandalcohol.ie/13635/1/RCGP_meth_guidance.pdf.
  103. Sofuoglu M, DeVito EE, Carroll KM. Pharmacological and behavioral treatment of opioid use disorder. Psychiatr Res Clin Pract 2019; 1: 4-15. https://doi.org/10.1176/appi.prcp.20180006
  104. Reddy S, Hui D, El Osta B, de la Cruz M, Walker P, Palmer JL, et al. The effect of oral methadone on the QTc interval in advanced cancer patients: a prospective pilot study. J Palliat Med 2010; 13: 33-8. https://doi.org/10.1089/jpm.2009.0184
  105. Khanna IK, Pillarisetti S. Buprenorphine - an attractive opioid with underutilized potential in treatment of chronic pain. J Pain Res 2015; 8: 859-70. https://doi.org/10.2147/JPR.S85951
  106. Fischer A, Jonsson M, Hjelmstrom P. Pharmaceutical and pharmacokinetic characterization of a novel sublingual buprenorphine/naloxone tablet formulation in healthy volunteers. Drug Dev Ind Pharm 2015; 41: 79-84. https://doi.org/10.3109/03639045.2013.846365
  107. Substance Abuse and Mental Health Services Administration (SAMHSA). Medication-assisted treatment (MAT): MAT medications, counseling, and related conditions - naltrexone [Internet]. Rockville (MD): SAMHSA; 2022. Available at: https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone.
  108. Kunzler NM, Wightman RS, Nelson LS. Opioid withdrawal precipitated by long-acting antagonists. J Emerg Med 2020; 58: 245-53. https://doi.org/10.1016/j.jemermed.2019.12.015
  109. Wesson DR, Ling W. The clinical opiate withdrawal scale (COWS). J Psychoactive Drugs 2003; 35: 253-9. https://doi.org/10.1080/02791072.2003.10400007
  110. Kim J, Shin SJ, Yoon J, Kim HS, Lee JW, Kim YS, et al. Recent trends in opioid prescriptions in Korea from 2002 to 2015 based on the Korean NHIS-NSC cohort. Epidemiol Health 2022; 44: e2022029. https://doi.org/10.4178/epih.e2022029
  111. Oh TK, Jeon YT, Choi JW. Trends in chronic opioid use and association with five-year survival in South Korea: a population-based cohort study. Br J Anaesth 2019; 123: 655-63. https://doi.org/10.1016/j.bja.2019.08.012
  112. Cho NR, Chang YJ, Lee D, Kim JR, Ko DS, Choi JJ. Trends in opioid prescribing practices in South Korea, 2009-2019: are we safe from an opioid epidemic? PLoS One 2021; 16: e0250972. https://doi.org/10.1371/journal.pone.0250972
  113. Noh Y, Heo KN, Yu YM, Lee JY, Ah YM. Trends in potentially inappropriate opioid prescribing and associated risk factors among Korean noncancer patients prescribed noninjectable opioid analgesics. Ther Adv Drug Saf 2022; 13: 20420986221091001.
  114. The Korea Orphan and Essential Drug Center (KOEDC). Example of request for supply of narcotic drugs [Internet]. Seoul: KOEDC; 2021. Available at: https://www.kodc.or.kr/cntnts/219.