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Resources Consulted for Opioids911-Safety

A Guide to Staying Safe and Preventing Unintentional Death While Taking Pain Medication. ZeroDeaths.org [online]. Undated.

AAPM et al. (American Academy of Pain Medicine, National Pain Foundation, American Pain Foundation, and National Hospice and Palliative Care Organization). Recommendations to Physicians Caring for Katrina Disaster Victims on Chronic Opioids. 2005.

AAPM, APS, ASAM (American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine. Definitions Related to the Use of Opioids for the Treatment of Pain. 2001. Access at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711509/

ACPA (American Chronic Pain Association). Consumer Guide to Pain Medication & Treatment - 2010. Access at: https://painnews.stanford.edu/news/...

Addicted to painkillers? New hope with advances in treatment. WebMD [online]. Undated.
Access at: https://www.webmd.com/mental-health/addiction/painkillers-and-addiction-narcotic-abuse

AHA (American Heart Association). 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005;112(24 Suppl). Access at: https://www.ahajournals.org/action/...

AHA (American Heart Association). American Heart Association Guidelines for CPR & ECC [website]. Access at: https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines

AHA (American Heart Association). Hands-Only CPR [website]. Access at: https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr

Anderson A, Fine PG, Fishman S. Opioid Prescribing: Clinical Tools and Risk Management Strategies [CME monograph]. American Academy of Pain Management. 2009. Access at: https://www.researchgate.net/publication/...

APA (American Psychiatric Association). DSM-5: The Future of Psychiatric Diagnosis [online]. 2010. Access at: https://psychiatry.org/dsm5

APF (American Pain Foundation). Addiction Basics [online]. Undated.

APF (American Pain Foundation). Chronic Pain and Opioid Treatment. 2008(Nov).

APF (American Pain Foundation). Pain Resource Guide: Getting the Help You Need. 2009.

APF (American Pain Foundation). Taking Stock: Monitoring, Safely Storing and Disposing of Your Medications. Pain Community News. 2010(Winter);10(1):1,4-5.

Argoff CE, Silvershein DI. A comparison of long- and short-acting opioids for the treatment of chronic noncancer pain: tailoring therapy to meet patient needs. Mayo Clin Proc. 2009;84(7):602-612. Access at: https://www.mayoclinicproceedings.org/article/S0025-6196(11)60749-0/fulltext

ASSA (American Sleep Apnea Association). Snore Score™. 2008. Access at: https://www.snorelab.com/faqs/

Bailey JE, Campagna E, Dart RC, et al. The underrecognized toll of prescription opioid abuse on young children. Annals Emerg Med. 2009;53(4):419-424. Access at: https://www.annemergmed.com/article/S0196-0644(08)01503-5/fulltext

Ballantyne JC, Mao J. Opioid therapy for chronic pain. NEJM. 2003;349(20):1943-1953.

Baxter J. Preventing and detecting the misuse of prescription opioids in patients with chronic nonmalignant pain. NIDA [online education]. 2009.

Bennett D, Burton AW, Fishman S, et al. Consensus panel recommendations for the assessment and management of breakthrough pain. Part 1: Assessment. P & T Journal. 2005;30(5):296-301. Access at: https://elib.tips/edoc/...

Bennett D, Burton AW, Fishman S, et al. Consensus panel recommendations for the assessment and management of breakthrough pain. Part 2: Management. P & T Journal. 2005;30(6):354-361. Access at: https://www.researchgate.net/publication/...

Best D, Lan-Ho M, Zador D, et al. Overdosing on opiates. Part 1-Causes. Drug & Alcohol Findings. 2000;4:6-20.

Breakthrough Pain in Patients with Chronic Noncancer Pain on Chronic Opioid Therapy. PainEDU [online]. 2010 (April). Access at: https://medicinetoday.com.au/2013/july/regular-series/...

Brown MA. FAQ: When opioids have been prescribed for my chronic pain. American Pain Foundation [online].

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. National Opioid Use Guideline Group (NOUGG). 2010(Apr). Access at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215602/

Chicago Recovery Alliance. OD [online resources]. Access at: https://anypositivechange.org/

Chou R, Carson S. Drug Class Review on Long-Acting Opioid Analgesics. The Drug Effectiveness Review Project. Final Report. Portland, OR: Oregon Health & Science University; 2008. Access at: https://www.ohsu.edu/evidence-based-practice-center/derp-reports

Chou R, Fanciullo GJ, Fine PG, et al. APS/AAPM Clinical Guidelines For the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. J Pain. 2009(Feb);10(2):113-130. Access at: https://www.jpain.org/article/S1526-5900(08)00831-6/fulltext

Chu LF, Clark DJ, Angst MS. Opioid tolerance and hyperalgesia in chronic pain patients after one month of oral morphine therapy: A preliminary prospective study. Pain. 2006;7(1):43-48.

Colameco S. Opioid-induced sexual dysfunction: causes, diagnosis, & treatment. Pain Treatment Topics [online]. 2008(Apr). Access at: https://www.semanticscholar.org/paper/...

Compton P. Should Opioid Abusers Be Discharged From Opioid-Analgesic Therapy? Pain Treatment Topics [current comments]. 2008(Jan). Access at: https://pubmed.ncbi.nlm.nih.gov/18489627/

Compton P. The OIH Paradox: Can Opioids Make Pain Worse? Pain Treatment Topics [current comments]. 2008(Aug). Access at: https://thecolemaninstitute.com/tci-blog/opioids-make-pain-worse/

Consumer Reports. Do You Really Need That Opioid Prescription?. 2018. Access at: https://www.consumerreports.org/opioids/...

CPSO (College of Physicians and Surgeons of Ontario). CPSO Evidence-Based Recommendations for Medical Management of Chronic Non-Malignant Pain. 2000. Access at: https://pubmed.ncbi.nlm.nih.gov/17177763/

CSAT (Center for Substance Abuse Treatment). Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. TIP Series 43. DHHS Publication No. (SMA) 05-4048. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration; 2005. Available at: https://pubmed.ncbi.nlm.nih.gov/22514849/

CSAT (Center for Substance Abuse Treatment). Methadone-Associated Mortality: Background Briefing Report. CSAT Publication Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration; 2004. Available at: http://www.legalsideofpain.com/uploads/methadone_mortality_briefing.pdf

Dahan A. Respiratory depression with opioids. J Pain & Palliative Care Pharmacotherapy. 2007;21(1):63-66.

DEA (U.S. Drug Enforcement Agency). Rules - 2007: Issuance of Multiple Prescriptions for Schedule II Controlled Substances. Access at: https://www.federalregister.gov/documents/...

Dews TE, Mekhail N. Safe use of opioids in chronic noncancer pain. Cleveland Clin J Med. 2004;71(11):897-904. Access at: https://www.ccjm.org/content/71/11/897

Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. JAMA. 1992;268(16):2172-2302.

Estfan B, Walsh D. Opioids and ventilatory depression: to fear or not to fear! J Cancer Pain Symptom Pall. 2005;1(2):59-60.

FDA (U. S. Food & Drug Administration). Disposal by Flushing of Certain Unused Medicines: What You Should Know. Access at: https://www.fda.gov/drugs/safe-disposal-medicines/...

FDA (U. S. Food & Drug Administration). Drugs: Medication Guides. Access at: https://www.fda.gov/drugs/drug-safety-and-availability/medication-guides

FDA (U. S. Food & Drug Administration). Generic drugs: what you need to know. undated. Access at: https://www.fda.gov/drugs/generic-drugs/generic-drug-facts

FDA (U. S. Food & Drug Administration). Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. Access at: https://www.fda.gov/drugs/drug-approvals-and-databases/...

FDA (U. S. Food & Drug Administration). Risk Evaluation and Mitigation Strategies (REMS) for Extended Release and Long-Acting Opioid Analgesics. Review documents for Joint Meeting of the Anesthetic and Life Support Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee, July 22-23, 2010. Access at: https://www.fda.gov/drugs/information-drug-class/...

Feinberg S, Provenzano D, Fong A. ACPA Consumer Guide to Pain Medication & Treatment. 2010 ed. Rocklin, CA: American Chronic Pain Association. Access at: https://pubmed.ncbi.nlm.nih.gov/19670027/

Fine PG, Miaskowski CA, Brennan MJ. Opioid-based management of persistent and breakthrough pain. Pain Med News. 2009. Access at: https://www.painmedicinenews.com/download/0826_Select_SR_WM.pdf

Fine PG, Portenoy RK. A Clinical Guide to Opioid Analgesia. New York, NY: McGraw-Hill; 2004. Access at: https://www.tandfonline.com/doi/abs/...

Fishbain DA, Cutler RB, Rosomoff HL, Rosomoff RS. Can patients taking opioids drive safely? A structured evidence-based review. J Pain Palliat Care Pharmacother. 2002;16(1):9-28 Access at: https://pubmed.ncbi.nlm.nih.gov/14650448/

Fishman SM. Responsible Opioid Prescribing: A Physician's Guide. Washington, DC: Waterford Life Sciences; 2007. See: https://academic.oup.com/painmedicine/article/9/6/759/1909460

FSMB (Federation of State Medical Boards of the United States, Inc.). FSMB Model Policy for the Use of Controlled Substances for the Treatment of Pain. 2004. Access at: https://www.newswise.com/articles/...

Furlan AD, Sandoval JA, Mailis-Gagnon A, Tunks E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. Can Med Assoc J. 2006;174(11):1589-1594. Access at: https://www.cmaj.ca/content/cmaj/174/11/1589.full.pdf

Goodheart CR, Leavitt SB. Managing opioid-inducted constipation in ambulatory-care patients. Pain Treatment Topics [online]. 2006(Aug). Access at: https://paincommunity.org/blog/wp-content/...

Green TC, Heimer R, Grau LE. Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States. Addiction. 2008;103(6):979-989. Access at: https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02182.x

How to treat the poisoned patient. Patient Care. 1997(August):90-113.

HRC (Harm Reduction Coalition). Overdose [online resource section]. Access at: https://harmreduction.org/issues/overdose-prevention/...

IDMU (Independent Drug Monitoring Unit). Opiates and Driving Ability. Undated. Access at: http://www.idmu.co.uk/oldsite/opiatedrive.htm

Johnson SJ. Opioid Safety in Patients With Renal or Hepatic Dysfunction. Pain Treatment Topics [special report]. 2007. Access at: https://www.practicalpainmanagement.com/treatments/...

Kingsbury SJ, Simpson GM. Principles for starting, stopping, or switching medications. Psychiatry Svs. 2002;53(2):139-140.

Kral LA, Leavitt SB. Patient Instructions Handout: Safely Taking Oxycodone. Pain Treatment Topics [online]. 2007. Access at: https://pain-topics.org/opioid_rx/oxycodone.php

Lancashire Drug and Alcohol Action Team. OD999 [website]. Access at: https://www.lancashire.gov.uk/health-and-social-care/...

Leavitt SB. CDC Study Ties Opioid Analgesics to Birth Defects. Pain-Topics UPDATES [online]. March 10, 2011. Access at: https://www.cmaj.ca/content/194/5/E152

Leavitt SB. Managing an opioid overdose crisis: What to know. How to prevent overdose. What to do if it happens. Addiction Treatment Forum. 2007(Summer). Access at: https://www.hhs.gov/overdose-prevention/

Leavitt SB. Methadone Safety Handout for Patients. Pain Treatment Topics [online]. 2008. Access at: https://pain-topics.org/opioid_rx/methadone.php

Leavitt SB. Methadone-Drug Interactions. 4th Ed. Pain Treatment Topics [special report]. 2006(January). Access at: https://neaddictions.com/addiction/...

Lechnyr R, Lechnyr T. Mistakes made by chronic pain patients. Prac Pain Manage. 2007(Oct). Access at: https://www.practicalpainmanagement.com/resources/...

Managing persistent pain in older people: tips for the caregiver. PainKnowledge.org [online]. 2009. Access at: https://specialtycareclinics.com/blogs/...

Maxwell S, Bigg D, Stanczykiewicz K, Carlberg-Racich S. Prescribing naloxone to actively injecting heroin users: A program to reduce heroin overdose deaths. J Addict Dis. 2006;25(3):89-96.

McCaffery M, Pasero C. Understand your pain: taking oral opioid analgesics. Endo Pharmaceuticals. 2004. Access at: https://www.ncbi.nlm.nih.gov/books/NBK459161/

NPF (National Pain Foundation). Abrupt Withdrawal from Medications - Information and Caution. 2005 (Sept).

Overdose. Harm Reduction Communication, No. 9. New York: Harm Reduction Coalition; 1999(Fall).

Overdose: Everything You Need to Know. United Kingdom: National Treatment Agency for Substance Abuse; 2004. Access at: https://www.gov.uk/government/collections/...

PainKnowledge [online]. Pain: opioid therapy. 2009. Access at: https://www.iasp-pain.org/advocacy/iasp-statements/...

Payte JT. Methadone induction instructions to patients and significant others. CMG Induction Handout v7; 2003. Access at: https://www.atforum.com/pdf/PayteSafetyInstructions.pdf

Piper TM, Rudenstine S, Stancliff S, et al. Overdose prevention for injection drug users: Lessons learned from naloxone training and distribution programs in New York City. Harm Reduction J. 2007;4(3). Access at: https://harmreductionjournal.biomedcentral.com/articles/...

Preston A, Hunt N, Derricott J. Preventing overdose [briefing paper]. Exchange Campaigns/Department of Health. 2001. Access at: https://www.exchangesupplies.org/shopdisp_P601.php

Savage SR, Kirsh KL, Passik SD. Challenges in Using Opioids to Treat Pain in Persons With Substance Use Disorders. Addiction Science & Clinical Practice [NIDA]. 2008;4(2). Access at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797112/

SMARxT Disposal [online]. Responsible medication disposal safeguards lives and protects the environment. Access at: https://www.smarxtdisposal.net/

Smith HS. Opioid Metabolism. Mayo Clin. Proc. 2009;84(7):613-624. Access at: https://www.mayoclinicproceedings.org/article/S0025-6196(11)60750-7/fulltext

Sporer KA, Kral AH. Prescription naloxone: a novel approach to heroin overdose prevention. Ann Emergency Med. 2007;49(2):172-177.

Sporer KA. Acute heroin overdose. Ann Intern Med. 1999;130(7):584-590.

Mountsinai.org [online]. Palliative Care. Undated. Access at: https://www.mountsinai.org/care/palliative-care

Tarn DM, Heritage J, Paterniti DA, et al. Physician communication when prescribing new medications. Arch Intern Med. 2006;166(17):1855-1862.

Thompson AR, Ray JB. The importance of opioid tolerance: a therapeutic paradox. J Am Coll Surg. 2003;196(3):321-324.

Toombs JD. Commonsense Opioid-Risk Management in Chronic Noncancer Pain: A Clinician's Perspective. Pain Treatment Topics [special report]. 2007(Aug). Access at: https://www.practicalpainmanagement.com/treatments/...

Toombs JD. Oral Methadone Dosing for Chronic Pain: A Practitioner's Guide. Pain Treatment Topics [special report]. Updated 2008(Mar). Access at: https://www.pbm.va.gov/PBM/clinicalguidance/...

Trescot AM, Boswell MV, Atluri SL, et al. Opioid guidelines in the management of chronic non-cancer pain. Pain Physician. 2006;9(1):1-40. Access at: https://www.painphysicianjournal.com/2006/january/2006;9;1-40.pdf

Trescot AM, Datta S, Lee M, Hansen H. Opioid Pharmacology. Pain Physician; 2008;11:S133-S153. Access at: https://pubmed.ncbi.nlm.nih.gov/18443637/

Trescot AM, Helm S, Hansen H, et al. ASIPP guidelines: opioids in the management of chronic non-cancer pain - an update of American

Society of the Interventional Pain Physicians' guidelines. Pain Physician. 2008;11(Suppl 2):S5-S62. Access at: https://www.drugsandalcohol.ie/18248/1/...

Utah Department of Health. Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain. 2009. Access at: https://health.utah.gov/prescription/guidelines.html

VA/DoD (Department of Veterans Affairs and the Department of Defense). VA/DoD Clinical Practice Guideline for the Management of Opioid Therapy for Chronic Pain. 2010(ver 2.0). Access at: https://www.healthquality.va.gov/guidelines/Pain/cot/

Washington State Agency Medical Directors' Group. Interagency Guideline on Opioid Dosing for Chronic Non-Cancer Pain: An Educational Pilot to Improve Care and Safety With Opioid Treatment. 2007(Mar). Access at: https://www.agencymeddirectors.wa.gov/Files/OpioidGdline.pdf

Webster LR, Choi Y, Desai H, et al. Sleep-disordered breathing and chronic opioid therapy. Pain Medicine. 2008;9(4):425-432. Access abstract at: https://academic.oup.com/painmedicine/article/9/4/425/1823725?login=false

Webster LR, Dove B. Avoiding Opioid Abuse While Managing Pain: A Guide for Practitioners. North Branch, MN: Sunrise River Press; 2007.

Weissman DE. Is it pain or addiction? Fast fact and concepts #68. 2nd ed. EPERC. 2009. Access at: https://www.agencymeddirectors.wa.gov/files/opioidgdline.pdf

Young SM, Ballantyne JC, Domino FJ. Balancing clinical and risk management considerations for chronic pain patients on opioid therapy. American Academy of Family Physicians [monograph]. 2008. Access at: https://www.aafp.org/online/etc/...

Zichterman A. Opioid pharmacology and considerations in pain management. US Pharm. 2007(May). Access at: https://pubmed.ncbi.nlm.nih.gov/32279731/