In the past 15 years, there have been marked increases in the use of opioids to treat
chronic non-cancer pain.
1
,
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,
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Yet, there remains little to no clinical evidence supporting the long-term effectiveness
of this class of drugs or therapeutics for this indication.
4
Contemporaneous with the increase in opioid prescriptions, there has been a commensurate
rise in opioid misuse.
2
,
5
There are also serious risks associated with long-term use of non-steroidal anti-inflammatory
drugs (NSAIDs), a comparable analgesic, such as gastrointestinal bleeding and renal
disease.
6
Within the context of these known risks and recommendations to use both classes primarily
for acute pain (except cautionary use for select conditions when there is clear longitudinal
symptom improvement), it is unclear how often opioids and NSAIDs are prescribed long
term, despite potential risks.
6
,
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,
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,
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This study compares long-term use of both classes for patients with non-cancer low
back pain in a large healthcare system.To read this article in full you will need to make a payment
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References
- Policies and events affecting prescription opioid use for non-cancer pain among an insured patient population.Pain Physician. 2014; 17: 205-216
- Association between opioid prescribing patterns and opioid overdose-related deaths.JAMA. 2011; 305: 1315-1321https://doi.org/10.1001/jama.2011.370
- Trends in long-term opioid therapy for chronic non-cancer pain.Pharmacoepidemiol Drug Saf. 2009; 18: 1166-1175https://doi.org/10.1002/pds.1833
- Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain.J Pain. 2009; 10: 113-130https://doi.org/10.1016/j.jpain.2008.10.008
- Vital signs: overdoses of prescription opioid pain relievers—United States, 1999—2008.MMWR Morb Mortal Wkly Rep. 2011; 60: 1487-1492
- Nonsteroidal anti-inflammatory drugs in the treatment of low back pain.J Pain Res. 2012; 5: 579-590
- ACOEM practice guidelines: opioids for treatment of acute, subacute, chronic, and postoperative pain.J Occup Environ Med. 2014; 56: e143-e159https://doi.org/10.1097/JOM.0000000000000352
- Management of persistent pain in the older patient: a clinical review.JAMA. 2014; 312: 825-836https://doi.org/10.1001/jama.2014.9405
- Guideline for prescribing opioids to treat pain in injured workers.Phys Med Rehabil Clin N Am. 2015; 26: 453-465https://doi.org/10.1016/j.pmr.2015.04.005
- Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.Pain. 2015; 156: 1145-1152https://doi.org/10.1097/j.pain.0000000000000170
Article info
Publication history
Published online: March 09, 2016
Identification
Copyright
© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
