Codeine and oxycodone use in patients with chronic rheumatic disease pain

Ytterberg, Steven R.; Mahowald, Maren L.; Woods, Sharon R.

doi:10.1002/1529-0131(199809)41:9<1603::aid-art10>3.0.co;2-u

Cited by 90 publications

(64 citation statements)

References 43 publications

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“…They are also drugs inducing less organic toxicity as compared to anti-inflammatory drugs, and in studies using single dose of opioids there has been less cognitive impairment as compared to benzodiazepines 33 . In hospices treating patients with well-defined chronic pain, opioid abuse and addiction rates are very low 34,35 .…”

Section: Use Of Opioids In the Elderlysupporting

confidence: 80%

Recommendations for the use of opioids in Brazil: Part II. Use in children and the elderly

2014

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BACKGROUND AND OBJECTIVES: Pain management in age extremes and in children still requires attention and paradigms review. There are several diseases or procedures inducing pain from the neonatal period to adolescence. In the elderly, there is higher prevalence of degenerative diseases which induce acute and chronic pain. This study aimed at discussing recommendations for the use of opioid in neonates, children and the elderly. CONTENTS:This review has addressed the use of opioids in the neonatal period, in older children and in the elderly, their indications, drugs used, doses, risks, complications and recommendations. CONCLUSION: The use of opioids in age extremes is still a challenge. However, ongoing education about the subject is needed, encouraging clinical trials and the development of evidence-based recommendations. The safe use of such agents in correct indication and proportion for pain relief decreases risks and should be the basis for good clinical practice. Keywords: Children, Elderly, Opioids. RESUMO JUSTIFICATIVA E OBJETIVOS:

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Section: Use Of Opioids In the Elderlysupporting

confidence: 80%

Recommendations for the use of opioids in Brazil: Part II. Use in children and the elderly

2014

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“…[52] Also, administrative restrictions have generated claims of lowered access for needy patients or eroded bilateral trust. [53] In our experience and in that of others, patients with CNCP managed with opioids may be expected to develop tolerance and even physical dependence over time, but not the aberrant behaviors, including rapid dose escalation, associated with psychological addiction or drug seeking for profit [54,55,56]. No mood and/or cognitive deficits occurred post-therapy in at least one study of non-cancer pain patients, as compared to controls-in fact, medication reduced anxiety and hostility [57].…”

Section: Discussionmentioning

confidence: 99%

Survey of Physician Perspective towards Management of Pain for Chronic Conditions in the Emergency Department

Sop¹,

Smith²,

Alsalman³

et al. 2017

MCMR

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Abstract. Sickle cell disease (SCD) pain is often acute-on-chronic, likening it to other chronic acuteon-chronic pain conditions. Pain treatment of SCD was already reported as inadequate prior to the current opioid epidemic, but attitudes underlying treatment were understudied. Understanding these attitudes prior to the current epidemic would be revealing. Therefore in 1997, before the current opioid epidemic, we surveyed physicians' attitudes toward pain management and treatment preferences for acute pain exacerbations in the Emergency Department in SCD versus those of chronic pancreatitis and chronic low back pain, two other acute-on-chronic pain diseases. Thirty-nine residency trainees were surveyed in a level one triage hospital. Resident estimates of the rate of opioid addiction in SCD were higher than estimates in both chronic pancreatitis and chronic low back pain. Most residents relied on their personal clinical experience rather than external sources of data or knowledge as the most important driver when they managed chronic pain. This survey research shows that, predating the current opioid epidemic, there was both a backdrop of opioidphobia and a bias against treating SCD pain compared to other chronic pain conditions among our sample. Repeating this survey research among current training physicians, along with surveys of other attitudes, would provide useful comparisons.

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“…The third National Health and Nutrition Examination Survey found similar rates of analgesic medication use (8); however, these data are cross-sectional and do not allow one to accurately depict the antecedent predictors of opioid analgesic use. Several other small studies from rheumatology practices have examined opioid use in specific patient populations cared for by selected providers (9,10). These studies may not represent typical community-based prescription patterns.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment for rheumatoid arthritis should be aimed at reducing inflammation with disease-modifying antirheumatic drugs, but pain control is a major goal and may not always be achieved with antirheumatic treatments. One prior survey of subjects attending a rheumatology practice at a Veterans Affairs hospital found a proportion of patients with rheumatoid arthritis taking chronic opioids similar to this study (9). However, neither prior studies nor the present study answer several important questions about opioid use in persons with rheumatoid arthritis.…”

mentioning

confidence: 99%

Prescription opioid use among older adults with arthritis or low back pain

Solomon

Avorn

Wang

et al. 2006

Arthritis & Rheumatism

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Objective. To examine patterns of chronic opioid use in selected groups with arthritis and low back pain and compare them with patterns among persons with ischemic heart disease. Methods. The study database consisted of Medicare beneficiaries who were enrolled in a drug benefit program for low-tomoderate income Pennsylvania residents. We identified selected patients who had a diagnosis of rheumatoid arthritis, osteoarthritis, chronic low back pain, or ischemic heart disease since 1995. Chronic opioid use, defined as at least six 30-day prescriptions in a year, was the endpoint of interest. We examined the proportion of patients meeting this definition during the period 1996 -2001 and determined predictors based on multivariable Cox proportional hazards models. Results. Four percent of subjects with rheumatoid arthritis used opioids chronically in 2001, compared with <1% in each of the other groups. There was no increase in the chronic use of opioids over the 6-year study period. Low-potency opioids were the most commonly prescribed preparations for chronic users from all patient groups. The prior use of medicines for psychiatric illness, including benzodiazepines or barbiturates, was associated with chronic prescription opioid use across all diagnoses. However, subjects with a prior diagnosis of psychiatric illness were less likely to receive chronic opioids. Conclusion. Chronic opioid use is relatively uncommon, even among older individuals with arthritis or low back pain. The proportion of these individuals receiving such medicines has not increased in the late 1990s. There seems to be a complex relationship between psychiatric medication use, psychiatric diagnoses, and the use of chronic opioids among these individuals.

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Codeine and oxycodone use in patients with chronic rheumatic disease pain

Cited by 90 publications

References 43 publications

Recommendations for the use of opioids in Brazil: Part II. Use in children and the elderly

Recommendations for the use of opioids in Brazil: Part II. Use in children and the elderly

Survey of Physician Perspective towards Management of Pain for Chronic Conditions in the Emergency Department

Prescription opioid use among older adults with arthritis or low back pain

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