title: Opioids in chronic noncancer pain.
abstract: Chronic noncancer pain is highly prevalent with associated negative effects on function and quality of life of the individuals involved. Opioids have been shown to decrease pain and improve function in some patients with chronic noncancer pain, but they are not always effective and are associated with multiple complications, including drug misuse, abuse and diversion. Furthermore, the effectiveness of opioids in decreasing pain and improving function has not been proven conclusively, resulting in continued uncertainty about long-term benefits of opioids for chronic noncancer pain. Ideally, in modern medicine, clinical decisions are made based on information derived from high quality evidence. Since no such evidence exists for chronic opioid therapy in chronic noncancer pain, this review describes various aspects of opioid therapy in chronic noncancer pain, including adherence monitoring, along with a ten-step process outlining the principles of effective and safe opioid use.
authors.affiliation: Pain Management Center of Paducah, Paducah, KY 42003, USA. drm@asipp.org
authors.forename: Laxmaiah
authors.initials: L
authors.lastname: Manchikanti
authors.forename: Ramsin
authors.initials: R
authors.lastname: Benyamin
authors.forename: Sukdeb
authors.initials: S
authors.lastname: Datta
authors.forename: Ricardo
authors.initials: R
authors.lastname: Vallejo
authors.forename: Howard
authors.initials: H
authors.lastname: Smith
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D002908:Chronic Disease; D006801:Humans; D009293:Opioid-Related Disorders / Q000209:etiology / Q000276:immunology / Q000652:urine; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life
chemical_list: D000701:Analgesics, Opioid