What Are We Treating with Chronic Opioid Therapy?

CHRONIC PAIN (LJ CROFFORD, SECTION EDITOR)

DOI: 10.1007/s11926-012-0311-1

Cite this article as:
Krashin, D., Sullivan, M. & Ballantyne, J. Curr Rheumatol Rep (2013) 15: 311. doi:10.1007/s11926-012-0311-1
Part of the following topical collections:
  1. Topical Collection on Chronic Pain

Abstract

The recent increase in the number of patients taking opioids chronically for pain has not yielded the expected benefits in reduction of symptoms and improved function. Chronic pain patients typically respond well initially to opioid medications, but regular use is associated with adverse psychological and physical effects. Patients with significant psychiatric comorbidity and substance use issues are more likely to stay on opioids and to receive higher doses. In the common rheumatological conditions of fibromyalgia and osteoarthritis, opioid treatment is of limited benefit because of lack of efficacy and prominent side effects. Chronic opioid therapy may be more usefully regarded as a form of comfort care, reserved for those patients who have exhausted other treatments and prospects of recovery.

Keywords

Chronic pain Opioids Chronic opioid therapy Palliative care Fibromyalgia Osteoarthritis Comfort care Treatment Outcomes 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Daniel Krashin
    • 1
  • Mark Sullivan
    • 2
  • Jane Ballantyne
    • 3
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleUSA
  2. 2.Department of PsychiatryUniversity of WashingtonSeattleUSA
  3. 3.Department of Anesthesiology and Pain MedicineUniversity of WashingtonSeattleUSA