• 1

    Ruoff G: Management of pain in patients with multiple health problems: a guide for the practicing physician. .Am J Med 105::53S. ,1998. .

  • 2

    Caudill MA, Holman GH, Turk D: Effective ways to manage chronic pain. .Patient Care 154.,1996. .

  • 3

    Nikolaus T, Zeyfang A: Pharmacological treatments for persistent non-malignant pain in older persons. .Drugs Aging 21::19. ,2004. .

  • 4

    Crook J, Rideout E, Browne G: The prevalence of pain complaints in a general population. .Pain 2::157. ,1997. .

  • 5

    Brattberg G, Parker MG, Thorslund M: A longitudinal study of pain: reported pain from middle age to old age. .Clin J Pain 13::144. ,1997. .

  • 6

    Badley EM, Tennant A: Changing profile of joint disorders with age: findings from a postal survey of the population of Calderdale, West Yorkshire, United Kingdom. .Ann Rheum Dis 51::366. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Wolfe F, Ross K, Anderson J, et al: The prevalence and characteristics of fibromyalgia in the general population. .Arthritis Rheum 38::19. ,1995. .

  • 8

    Campomizzi ME: Pharmacologic management of acute pain: the basics. .Pharmacy Practice News (May):31. ,2004. .

  • 9

    Nist JB: Liability for overprescription of controlled substances: can it be justified in light of current practice of undertreating pain?. J Leg Med 23::85. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Reisine T, Pasternak G: “Opioid Analgesics and Antagonists,” in Goodman and Gilman’s The Pharmacological Basis of Therapeutics, ed by JG Hardman, LE Limbird, p 521, McGraw-Hill, New York. ,1996. .

  • 11

    The opiates. Available at: http://www.drugtext.org/sub/opiat1.html. Accessed August 8. ,2004. .

  • 12

    MacPherson RD: Pharmacological basis of contemporary pain management. .Pharmacol Ther 88::163. ,2000. .

  • 13

    Mycek M, Harvey RA, Champe PC: “Opioid Analgesics and Antagonists,” in Lippincott’s Illustrated Reviews: Pharmacology, 2nd Ed, ed by M Mycek, RA Harvey, PC Champe, p 133, Lippincott-Raven, Philadelphia. ,1997. .

  • 14

    Opioid use in clinical practice. Pharmacy Times. Available at: https://secure.pharmacytimes.com/lessons/200308-02.asp. Accessed July 31. ,2004. .

  • 15

    Barkin RL, Barkin D: Pharmacologic management of acute and chronic pain: focus on drug interactions and patient-specific pharmacotherapeutic selection. .South Med J 94::756. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Novak KK (ed): Drug Facts and Comparisons: Updated Monthly, p 785, Wolters Kluwer Health, St Louis. ,2004. .

  • 17

    Martin EW: Pharmacologic management of foot pain in the older patient. .JAPMA 94::98. ,2004. .

  • 18

    Controlled Substances Act, 21 USC §801 (1970)..

  • 19

    Acute pain management: operative or medical procedures and trauma. Available at: http://www.ahcpr.gov/clinic/cpgarchv.htm. Accessed September 1, 2004..

  • 20

    Beauregard L, Pomp A, Choiniere M: Severity and impact of pain after day-surgery. .Can J Anaesth 45::304. ,1998. .

  • 21

    Coley KC, Williams BA, DaPos SV, et al: Retrospective evaluation of unanticipated admissions and readmissions after same day surgery and associated costs. .J Clin Anesth 14::349. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Apfelbaum JL, Chen C, Mehta SS, et al: Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. .Anesth Analg 97::534. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Mercadante S: Opioid rotation for cancer pain: rationale and clinical aspects. .Cancer 86::1856. ,1999. .

  • 24

    Beaver WT, Wallenstein SL, Houde RW, et al: A comparison of the analgesic effects of pentazocine and morphine in patients with cancer. .Clin Pharmacol Ther 7::740. ,1966. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Lawlor P, Turner K, Hanson J, et al: Dose ratio between morphine and hydromorphine in patients with cancer pain: a retrospective study. .Pain 72::79. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Mahler DL, Forrest WH: Relative analgesic potencies of morphine and hydromorphone in postoperative pain. .Anesthesiology 42::602. ,1975. .

  • 27

    McQuay H: Opioids in pain management. .Lancet 353::2229. ,1999. .

  • 28

    Campora E, Merlini L, Pace M, et al: The incidence of narcotic induced emesis. .J Pain Symptom Manage 6::L428. ,1991. .

  • 29

    Portenoy RK: Opioid therapy for chronic nonmalignant pain: a review of the critical issues. .J Pain Symptom Manage 11::203. ,1996. .

  • 30

    Green CR, Anderson KO, Baker TA, et al: The unequal burden of pain: confronting racial and ethnic disparities in pain. .Pain Med 4::277. ,2003. .

  • 31

    Weisse CS, Sorum PC, Dominguez RE: The influence of gender and race on physicians’ pain management decisions. .J Pain 9::505. ,2003. .

    • Search Google Scholar
    • Export Citation
  • 32

    Hoffmann DE, Tarzian AJ: Achieving the right balance in oversight of physician opioid prescribing for pain: the role of state boards. .J Law Med Ethics 31::21. ,2003. .

    • Search Google Scholar
    • Export Citation
  • 33

    Mendelson D: Legal liability for pain management involving opioid medication: an American perspective. .J Law Med 10::145. ,2002. .

  • 34

    Mitka M: Abuse of prescription drugs: is a patient ailing or addicted?. JAMA 283::1126. ,2000. .

  • 35

    EHS: Mosby’s Drug Consult. Available at: http://www.mosbysdrugconsult.com/DrugConsult/. Accessed July 30. ,2004. .

  • 36

    Gibbs LS, Haddox JD: Lawful prescribing and the prevention of diversion. .J Pain Palliat Care Pharmacother 17::5. ,2003. .

A Review of Opioid Analgesics Frequently Prescribed by Podiatric Physicians

Robert G. Smith Private practice, Shoe String Podiatry, 723 Lucerne Cir, Ormond Beach, FL 32174.

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The unpleasant and subjective sensation resulting from a noxious sensory stimulus defines the phenomenon of pain. The podiatric physician is no stranger to the difficulties in achieving optimal pain therapy. Podiatric physicians must develop analgesic regimens to treat patients with acute, chronic, and postoperative pain. Because opioid therapy is the cornerstone of the pharmacologic management of acute and chronic pain, this review focuses on the prescribing of opioid analgesics to treat lower-extremity pain. The pharmacology of frequently prescribed opioids is introduced. Then, criteria for selecting appropriate opioid analgesics as found in the current medical literature are reported. Finally, a review of the literature describing legal and ethical considerations regarding the prescribing of opioid analgesics is presented. (J Am Podiatr Med Assoc 96(4): 367–373, 2006)