title: Long-term use of opioids in 210 officially registered patients with chronic noncancer pain in Taiwan: A cross-sectional study.
abstract: OBJECTIVE
  Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids.
  
  
  METHODS
  An observational cross-sectional survey using the Taiwanese version of Brief Pain Inventory was conducted among outpatients with chronic noncancer pain registered by the Taiwan Food and Drug Administration. Patients were also asked about their sexual behavior, depression, opioid misuse behaviors, and use of complementary and alternative medicine.
  
  
  RESULTS
  For 210 of 328 outpatients (64.0%), the median pain duration was 96 months and opioid treatment duration was 57 months. The median morphine equivalent dose was 150 mg/d, with 30.5% of patients exceeding the daily watchful dose, defined as 200 mg of morphine equivalent dose. Pain reduction after taking opioids was ∼50% in the past week. The top three diagnoses were chronic pancreatitis, spinal cord injury, and neuralgia. The leading side effects were constipation (46.7%), and decreased sexual desire (69.5%) and satisfaction (57.9%). Depression was currently diagnosed in 55.2% of patients. Twenty patients (9.5%) displayed at least one aberrant behavior in the past month. Only 76 (36.2%) patients had ever received nerve block procedures, and 118 (56.2%) tried complementary and alternative medicine.
  
  
  CONCLUSIONS
  This nationwide survey described the concurrent pain intensity, daily function, and various adverse effects by long-term opioids among 210 monitored outpatients with chronic noncancer pain in Taiwan. More efforts are suggested to reduce opioid prescriptions in the 30% of patients exceeding daily watchful dose.
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Tso-Chou
authors.initials: TC
authors.lastname: Lin
authors.affiliation: Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Luo-Ping
authors.initials: LP
authors.lastname: Ger
authors.affiliation: Naples Anesthesia and Pain Associates, Naples, FL, USA.
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Pergolizzi
authors.affiliation: Department of Pharmaceutical Sciences, School of Pharmacy, Temple University, Philadelphia, PA, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Raffa
authors.affiliation: Department of Education and Research, Taipei City Hospital-Renai Branch, School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ju-O
authors.initials: JO
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: stho@vghtpe.gov.tw.
authors.forename: Shung-Tai
authors.initials: ST
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D059350:Chronic Pain / Q000188:drug therapy* / Q000209:etiology; D003248:Constipation / Q000139:chemically induced; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D009437:Neuralgia / Q000150:complications; D010147:Pain Measurement; D050500:Pancreatitis, Chronic / Q000150:complications; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012042:Registries; D019529:Sexuality / Q000187:drug effects; D013119:Spinal Cord Injuries / Q000150:complications; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
keywords: chronic pain; noncancer; opioid