Long-term use of opioids for complex chronic pain

Rational use of opioids for management of chronic nonterminal pain.

Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Nonmedical use of prescription opioids, diversion, and overdose deaths have also increased sharply, sparking concern about the safety of these medications. Physicians considering initiation or continuation of opioid t...

Cautionary guidelines for the use of opioids in chronic pain.

Guidelines for the use of opioids in the treatment of chronic pain have recently been proposed by the American Academy of Addiction Psychiatry. Older guidelines proposed by American pain organizations had the effect of liberalizing opioid prescription. In recent years, dramatic increases in prescribed opioids have been followed by equally dramatic rises in morbidity and mortality from prescript...

Opioids for chronic noncancer pain

The number of available opioid preparations, each with differing chemical properties, structure and opioid receptor affinity, increases with time. The efficacy of these opioids in the treatment of pain arising from a diverse range of disorders is beyond question. With the passage of time, the list of those conditions where an opioid is recommended as a treatment option increases, and that list ...

Opioids in chronic pain.

The aim in using opioid drugs in chronic pain is optimal pain relief with a minimum of side effects. A rational approach requires understanding of the clinical pharmacology of opioids given by a variety of routes, for the differences between routes may be greater than the differences between drugs given by the same route. Those using opioids in chronic pain differentiate between their clinical ...

The appropriateness of long-term opioids to treat chronic back pain.