Continuous opioid treatment for chronic noncancer pain: a time for moderation in prescribing.
Physicians have embraced the concept of long-term opioid treatment for chronic noncancer pain (CNCP), as evidenced by increased prescribing. Many patients have benefited from more liberal opioid prescribing, but many have not, and prescription opioid abuse has risen significantly coincident with increased prescribing. Because of the potentially serious adverse effects of opioids, physicians must balance potential benefits against risks, especially in individuals at risk for opioid misuse, abuse, or dependence. This article reviews long-term, continuous opioid treatment of CNCP, current treatment guidelines, addiction risk stratification, opioid-induced hyperalgesia, and endocrine dysfunction.
Colameco
Stephen
S
Department of Family Medicine, University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine, Stratford, NJ, USA. scolamec@yahoo.com
Coren
Joshua S
JS
Ciervo
Carman A
CA
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D004363:Drug Utilization; D006801:Humans; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D018570:Risk Assessment
D000701:Analgesics, Opioid