Over the past two decades, there has been a significant increase in the prescribing of opioids, with associated increases in opioid addiction and overdose deaths. This article reviews the evidence for the effectiveness and risk of developing an opioid use disorder (OUD) in those patients treated with chronic opioid therapy (COT) for chronic non-cancer pain (CNCP). Rates of development of OUD range from 0–50 %, and aberrant drug related behaviors (ADRBs) are reported to be 20 %. Health care providers must properly assess, screen, and carefully monitor patients on COT utilizing evidence-based tools.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Rosdahl CB, Kowalski MT. Textbook of basic nursing. Lippincott Williams & Wilkins. 2007. p. 704.
IASP curriculum outline on pain for nursing. 2014. https://www.iasp-pain.org/Education/CurriculumDetail.aspx?ItemNumber=2052. 2015.
Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61(8):807–16. doi:10.1001/archpsyc.61.8.807.
Sullivan MD, Ballantyne JC. What are we treating with long-term opioid therapy? Arch Intern Med. 2012;172(5):433–4. doi:10.1001/archinternmed.2011.2156.
Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005;6(6):432–42. doi:10.1111/j.1526-4637.2005.00072.x.
Minozzi S, Amato L, Davoli M. Development of dependence following treatment with opioid analgesics for pain relief: a systematic review. Addiction. 2013;108(4):688–98. doi:10.1111/j.1360-0443.2012.04005.x.
McAuliffe WE. A critique of Minozzi et al.’s pain relief and dependence systematic review. Addiction. 2013;108(6):1162–9. doi:10.1111/add.12181.
Fishbain DA, Cole B, Lewis J, Rosomoff HL, Rosomoff RS. What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review. Pain Med. 2008;9(4):444–59. doi:10.1111/j.1526-4637.2007.00370.x.
Martell BA, O’Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Ann Intern Med. 2007;146(2):116–27.
Moeller MR, Hammer K, Engel O. Poppy seed consumption and toxicological analysis of blood and urine samples. Forensic Sci Int. 2004;143(2-3):183–6. doi:10.1016/j.forsciint.2004.03.027.
Roux P, Sullivan MA, Cohen J, Fugon L, Jones JD, Vosburg SK, et al. Buprenorphine/naloxone as a promising therapeutic option for opioid abusing patients with chronic pain: reduction of pain, opioid withdrawal symptoms, and abuse liability of oral oxycodone. Pain. 2013;154(8):1442–8. doi:10.1016/j.pain.2013.05.004.
The author would like to acknowledge Dr. Kavita Babu for her contributions to this manuscript.
Conflicts of Interest
Sources of Funding
About this article
Cite this article
Salsitz, E.A. Chronic Pain, Chronic Opioid Addiction: a Complex Nexus. J. Med. Toxicol. 12, 54–57 (2016). https://doi.org/10.1007/s13181-015-0521-9
- Chronic pain
- Alcohol dependence
- Drug dependence