title: Opioids for the treatment of chronic noncancer pain.
abstract: Increasingly, opioids are used to treat chronic noncancer pain. While opioids are well recognized for their effectiveness in treating acute pain, the evidence supporting the benefits for the treatment of chronic pain is less well established. Improvement of both pain and function should be considered goals of therapy. Patients with chronic pain have a higher incidence of preexisting psychological disorders. Adverse effects of opioid therapy include dependence, overdose, and withdrawal. Risk factors for poor outcomes with opioid therapy are identified, and include preexisting mental illness and dose prescribed. Recommended strategies to more safely use opioids are discussed, including tools for identifying high-risk patients. The evidence supporting the use of treatment agreements and urine drug testing to reduce the effects of adverse outcomes is limited.
authors.affiliation: Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA. ewarner@health.usf.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Warner
mesh_terms: D000465:Algorithms; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease; D004335:Drug and Narcotic Control; D006801:Humans; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000517:prevention & control; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D063487:Prescription Drug Misuse; D018570:Risk Assessment; D012307:Risk Factors; D015813:Substance Abuse Detection; D016482:Urinalysis
chemical_list: D000701:Analgesics, Opioid