Opioids are increasingly used for the treatment of chronic noncancer pain, but this practice remains controversial. A new set of clinical recommendations attempts to guide clinicians through the issues.
References
Caudill-Slosberg, M. A., Schwartz, L. M. & Woloshin, S. Office visits and analgesic prescriptions for musculoskeletal pain in the US: 1980 vs 2000. Pain 109, 514–519 (2004).
Chou, R. et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J. Pain 10, 113–130 (2009).
Fishman, S. M. & Kreis, P. G. The opioid contract. Clin. J. Pain 18 (Suppl.), S70–S75 (2002).
Furlan, A. D., Sandoval, J. A., Mailis-Gagnon, A. & Tunks, E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ 174, 1589–1594 (2006).
Katz, W. A. Opioids for nonmalignant pain. Rheum. Dis. Clin. North Am. 34, 387–413 (2008).
Passik, S. D. et al. Monitoring outcomes during long-term opioid therapy for noncancer pain: results with the Pain Assessment and Documentation Tool. J. Opioid Manag. 1, 257–266 (2005).
Fitzcharles, M. A., Almahrezi, A. & Shir, Y. Pain: understanding and challenges for the rheumatologist. Arthritis Rheum. 52, 3685–3692 (2005).
Lamb, L., Pereira, J. X. & Shir, Y. Nurse case management program of chronic pain patients treated with methadone. Pain Manag. Nurs. 8, 130–138 (2007).
Fishbain, D. A., Cutler, R. B., Rosomoff, H. L. & Rosomoff, R. S. Can patients taking opioids drive safely? A structured evidence-based review. J. Pain Palliat. Care Pharmacother. 16, 9–28 (2002).
Fitzcharles, M. A., DaCosta, D., Ware, M. A. & Shir, Y. Patient barriers to pain management may contribute to poor pain control in rheumatoid arthritis. J. Pain 3, 300–305 (2009).
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M. -A. Fitzcharles has received speakers' honoraria from Biovale and Purdue Pharma.
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Fitzcharles, MA., Shir, Y. Opioid guidelines: helpful for the rheumatologist?. Nat Rev Rheumatol 5, 242–244 (2009). https://doi.org/10.1038/nrrheum.2009.63
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DOI: https://doi.org/10.1038/nrrheum.2009.63
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