Identifying optimal dosage regimes under safety constraints: An application to long term opioid treatment of chronic pain

Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety?

BACKGROUND For the past 30 years, opioids have been used to treat chronic nonmalignant pain. This study tests the following hypotheses: (1) there is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective; and (2) the main problem associated with the safety of such treatment - assessment of the risk of addiction - has been...

Long-Term Opioid Therapy for Chronic Pain.

Long-term opioid management for chronic noncancer pain.

BACKGROUND Opioid therapy for chronic noncancer pain (CNCP) is controversial due to concerns regarding long-term effectiveness and safety, particularly the risk of tolerance, dependence, or abuse. OBJECTIVES To assess safety, efficacy, and effectiveness of opioids taken long-term for CNCP. SEARCH STRATEGY We searched 10 bibliographic databases up to May 2009. SELECTION CRITERIA We searche...

Long-term opioid therapy for chronic pain and the risk of opioid addiction.

INTRODUCTION There has been a constant struggle to define the role of opioids in medical therapy, due to their potential for misuse, overuse, and addiction since pain is a completely subjective sensation, not amenable to objective measurement, and is intimately tied to emotion and the patient’s psychological well-being. Thus the medical decision to administer an opioid analgesic is an attempt t...

Opioid dependence and addiction during opioid treatment of chronic pain.

Throughout the long history of opioid drug use by humans, it has been known that opioids are powerful analgesics, but they can cause addiction. It has also been observed, and is now substantiated by multiple reports and studies, that during opioid treatment of severe and short-term pain, addiction arises only rarely. However, when opioids are extended to patients with chronic pain, and therapeu...