Improving Availability of Opioid Pain Medications: Testing the Principle of Balance in Latin America

Joranson, David E.

doi:10.1089/109662104322737377

Cited by 19 publications

(8 citation statements)

References 9 publications

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“…Denmark is among the most liberal in prescribing opioids for chronic pain, and has the highest per capita usage of prescription opioids in the world, most being used for chronic (noncancer) pain. 60,61 The findings of this study are at once surprising and worrying. Opioid users reported significantly more moderate to severe or very severe pain, poorer self-rated health, and lower QOL scores than nonusers.…”

Section: Epidemiologic Studiesmentioning

confidence: 72%

Efficacy of Opioids for Chronic Pain

Ballantyne

Shin

2008

The Clinical Journal of Pain

327

220

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Opioid therapy for chronic pain has been popularized over the past few decades, and a concern has arisen that the analgesic efficacy of opioids is not always maintained over prolonged courses of treatment despite dose escalation and stable pain. Considering the potentially serious adverse effects of opioids, the idea that pain relief could diminish over time may have a significant impact on the decision to embark on this therapy, especially in vulnerable individuals. Possible loss of analgesic efficacy is especially concerning, considering that dependence may make it hard to withdraw opioid therapy even in the face of poor analgesia. This article first reviews the evidence on opioid efficacy when used for the treatment of chronic pain, and concludes that existing evidence suggests that analgesic efficacy, although initially good, is not always sustained during continuous and long-term opioid therapy (months to years). The theoretical basis for loss of analgesic efficacy over time is then examined. Mechanisms for loss of analgesic efficacy proposed are pharmacologic tolerance, opioid-induced hyperalgesia, subtle and intermittent withdrawal, and a number of psychologic factors including loss of the placebo component.

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Section: Epidemiologic Studiesmentioning

confidence: 72%

Efficacy of Opioids for Chronic Pain

Ballantyne

Shin

2008

The Clinical Journal of Pain

327

220

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“…According to the World Health Organization (WHO) 20-25% of the adult population suffer from chronic pain 2-5 , with prevalence increasing with age due to functional limitations and difficulty in performing daily activities in the elderly 6 . Consequently, the prescription of opioids has increased dramatically worldwide over the last few decades for patients suffering from both chronic non-malignant and cancer pain [7][8][9][10][11][12][13][14][15][16][17][18][19] . This trend is partially due to the growing interest in providing better pain management 11 .…”

Section: Introductionmentioning

confidence: 99%

Persistence with opioid treatment in Germany in patients suffering from chronic non-malignant or cancer pain

Kostev¹,

Wartenberg²,

Richter³

et al. 2015

Current Medical Research and Opinion

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Our study showed that persistence with opioid treatment is associated with cancer pain, chronic comorbidities and depression, while younger age and chronic non-malignant pain (especially due to back pain) increase the possibility of opioid discontinuation. It will be the task of future studies to assess reasons for opioid discontinuation in more detail, which is an important step towards improving patient care and health outcomes.

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“…Se hizo una búsqueda de literatura científica en las bases de datos sobre instrumentos previamente diseñados, con el objetivo de detectar barreras para el acceso a opioides desde la perspectiva del paciente, sin encontrarse resultados al respecto. Se diseñó una encuesta estructurada, siguiendo las recomendaciones para la elaboración de instrumentos de recolección de datos [14], tomando en consideración las barreras encontradas en la literatura científica [15][16][17] y la opinión de expertos.…”

Section: Características Del Cuestionariounclassified

Disponibilidad y barreras para el acceso a opioides en Colombia: experiencia de una institución universitaria

et al. 2011

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ResumenIntroducción: El consumo de opioides es uno de los indicadores de la calidad de alivio de dolor de un país. Colombia presenta un bajo consumo de opioides para uso médico, debido a diferentes factores a lo largo de una cadena de distribución, cuyo usuario final es el paciente. Identificar las barreras que los pacientes encuentran para acceder a dichos medicamentos, permitirá sugerir soluciones. Métodos:Mediante una encuesta estructurada se determinaron las barreras para acceder a los opioides de pacientes con dolor crónico que asistieron a una consulta ambulatoria de dolor en una institución hospitalaria en Colombia.Resultados: Se encuestaron 24 pacientes entre 40 y 59 años. El 67% tuvo problemas para obtener el medicamento; 33% reportó problemas de autorización con sus aseguradoras; 33% tuvo inconvenientes con el sitio de entrega del medicamento; 17% tuvo problemas con la información sobre cómo hacer el trámite y, 17%, problemas con la fórmula médica.

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Improving Availability of Opioid Pain Medications: Testing the Principle of Balance in Latin America

Cited by 19 publications

References 9 publications

Efficacy of Opioids for Chronic Pain

Efficacy of Opioids for Chronic Pain

Persistence with opioid treatment in Germany in patients suffering from chronic non-malignant or cancer pain

Disponibilidad y barreras para el acceso a opioides en Colombia: experiencia de una institución universitaria

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