Opioids produce potent pain relief and thus remain the cornerstone of treatment for moderate to severe pain. Each year, roughly 45 million U.S. hospital patients receive an I.V. opioid for acute pain treatment (asamonitor.pub/36htwuR). Many of these patients have complex medical conditions that can be difficult to treat, such as old age, obesity, or renal impairment. The number of complex patient cases is reportedly growing, representing an increasing burden on the health care system (Clin Drug Investig 2015;35:53-59).

Although opioid analgesics are necessary, their overuse in clinical settings, diversion, and abuse has led to a difficult public health crisis. Additionally, many opioid side effects may complicate adequate dose exposure for analgesia, which can in rare instances be life-threatening. Most opioid overdose deaths in the U.S. occur from illegal heroin, fentanyl, and fentanyl analogs; however, prescription...

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