• Best Pract Res Clin Rheumatol · Oct 2013

    Review

    Long-term use of opioids for complex chronic pain.

    • Michael R Von Korff.
    • Group Health Research Institute, 1730 Minor Ave., Suite 1600, Seattle, WA 98101, USA. Electronic address: vonkorff.m@ghc.org.
    • Best Pract Res Clin Rheumatol. 2013 Oct 1;27(5):663-72.

    AbstractIncreased 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.Copyright © 2013 Elsevier Ltd. All rights reserved.

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