title: The opioid epidemic and the long-term opioid therapy for chronic noncancer pain revisited: a transatlantic perspective.
abstract: The rise of opioid prescriptions and associated deaths ('opioid epidemic') in North America has evoked worldwide discussions on the long-term efficacy and safety of long-term opioid therapy (LtOT) for chronic noncancer pain (CNCP). We discuss if the opioid epidemic is a real worldwide or a more North American phenomenon. We consider reasons of the opioid epidemic. We highlight differences in the appraisal of the evidence of recent systematic reviews on LtOT for CNCP of US and European authors. We discuss similarities and differences of recent North American and European guidelines on LtOT for chronic CNCP. We point out potential indications and contraindications of LtOT in CNCP syndromes.
authors.affiliation: Internal Medicine 1, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany.|Department of Psychosomatic Medicine & Psychotherapy, Technische Universität München, Ismaningerstraβe 22, D-81675 München, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Häuser
authors.affiliation: Day Clinic & Out Patient Department Pain Therapy, Universitätsmedizin Göttingen, D-37075 Göttingen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Petzke
authors.affiliation: Department of Palliative Medicine, University Hospital Bonn, Center of Palliative Care, Malteser Hospital Seliger Gerhard Bonn/Rhein-Sieg, D-53127 Bonn, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
authors.affiliation: Department of Neurology, Technische Universität München, Ismaningerstraβe 22, D-81675 München, Germany.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Tölle
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology*; D058872:Epidemics; D005060:Europe / Q000453:epidemiology; D006801:Humans; D009656:North America / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid
keywords: chronic noncancer pain; guidelines; long-term opioid therapy; misuse and addiction; mortality; opioid abuse; opioids; systematic review