Chronic pain and opiates: a call for moderation.
The prescription of opioid analgesics for chronic, nonterminal conditions continues as one of the most controversial and contentious issues in medicine. We have witnessed a full pendulum swing from the complete nihilism of the 1960s and 1970s to the careless zealotry of the 1990s. Neither extreme is good practice, and one hopes we are witnessing the dawn of a more moderate time of a sane and balanced appraisal of risk versus benefit in using these important tools.


OBJECTIVE
To present the case for thoughtful attention and moderation in prescribing opioids to treat chronic pain conditions.
Harden
R Norman
RN
Center for Pain Studies, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA. nharden@ric.org
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D011379:Prognosis; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000209:etiology / Q000517:prevention & control
D000701:Analgesics, Opioid