title: Long-term use of opioids for complex chronic pain.
abstract: Increased opioid prescribing for back pain and other chronic musculoskeletal pain conditions has been accompanied by dramatic increases in prescription-opioid addiction and fatal overdose. Opioid-related risks appear to increase with dose. Although short-term randomised trials of opioids for chronic pain have found modest analgesic benefits (a one-third reduction in pain intensity on average), the long-term safety and effectiveness of opioids for chronic musculoskeletal pain remains unknown. Given the lack of large, long-term randomised trials, recent epidemiologic data suggest the need for caution when considering long-term use of opioids to manage chronic musculoskeletal pain, particularly at higher dosage levels. Principles for achieving more selective and cautious use of opioids for chronic musculoskeletal pain are proposed.
authors: Group Health Research Institute, 1730 Minor Ave., Suite 1600, Seattle, WA 98101, USA. Electronic address: vonkorff.m@ghc.org.
authors: Michael R
authors: MR
authors: Von Korff
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D001416:Back Pain / Q000188:drug therapy*; D059350:Chronic Pain / Q000188:drug therapy*; D019468:Disease Management; D006801:Humans; D059352:Musculoskeletal Pain / Q000188:drug therapy*; D010147:Pain Measurement; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic pain; Effectiveness; Opioids; Safety