Opioids continue to be a topic of much discussion and controversy. At a packed special session at the World Congress on Pain to discuss the role of opioids in pain medicine, the speakers aimed ambitiously to find a path between undersupply in many developing countries and overconsumption elsewhere, particularly in the United States and Canada. Global consumption of opioids has increased at an a...

Pain is a common symptom in older people. It is possible that pain is underreported in older persons due to an incorrect belief that it is an inevitable part of aging. Opioid analgesics are potent medications, with confirmed efficacy for the treatment of moderate to severe pain. These drugs are commonly used in older persons. However, there is insufficient evidence regarding safety of opioids i...

Substance use behavior among youth is a complex peer-group phenomenon shaped by many factors. Peer influence, easily accessible prescription opioids, and youth’s socio-cultural environment play recognized roles in the initiation persistence of nonmedical opioid use. By altering physical surroundings social youth, in-person school closures may change risk factors for drug Acknowledging past rese...

OBJECTIVE To provide family physicians with a practical clinical summary of the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain, developed by the National Opioid Use Guideline Group. QUALITY OF EVIDENCE Researchers for the guideline conducted a systematic review of the literature on the effectiveness and safety of opioids for chronic noncancer pain, and dr...

Background. Fear of adverse events and occurrence of side effects are commonly cited by families and physicians as obstructive to appropriate use of pain medication in children. We examined evidence comparing the safety profiles of three groups of oral medications, acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids, to manage acute nonsurgical pain in children (<18 years) treated ...

OBJECTIVES To describe benzodiazepine and prescription opioid use by clients of drug treatment services and the sources of pharmaceuticals they use. DESIGN Structured face-to-face interviews on unsanctioned use of benzodiazepines and prescription opioids were conducted between January and July 2008. PARTICIPANTS Convenience sample of treatment entrants who reported regular (an average of ≥ ...

The spinal mechanisms of action of opioids under normal conditions are reasonably well understood. The spinal effects of opioids can be enhanced or reduced depending on pathology and activity in other segmental and nonsegmental pathways. This plasticity will be considered in relation to the control of different pain states using opioids. The complex and contradictory findings on the supraspinal...

The chronic use of opioids in humans, accompanied by the development of tolerance, is a dangerous phenomenon in its own right. However, chronic opioid use is often made more dangerous by the coconsumption of other substances. It has been observed that the blood level of opioids in postmortem analyses of addicts, who consumed ethanol along with the opioid, was much less than that observed in ind...

OBJECTIVE To review the evidence on safe and effective prescribing of opioids for chronic non-malignant pain. QUALITY OF EVIDENCE MEDLINE was searched using the terms "opioid effectiveness" and "adverse effects." There is strong evidence that opioids are effective for both nociceptive and neuropathic pain, but limited evidence that they are effective for pain disorder. There is little informa...