Opioid Treatments for Chronic Pain

Chou, Roger; Hartung, Daniel; Turner, Judith A.; Blazina, Ian; Chan, Brian; Levander, Ximena A.; McDonagh, Marian; Selph, Shelley; Fu, Rongwei; Pappas, Miranda

doi:10.23970/ahrqepccer229

Cited by 76 publications

(66 citation statements)

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“…A systematic review of RCTs comparing opioids with non-opioid analgesics found that nonopioid analgesics were superior to opioids in terms of improvement of physical function and tolerability in short-term (4-12 weeks) therapy of neuropathic, low back and osteoarthritis pain (moderate quality UptoDate evidence) (Welsch et al, 2015). These results are in accordance with the findings of the recent review on behalf of the US Agency for Healthcare Research and Quality (Chou et al, 2020).…”

Section: Publication and Disseminationsupporting

confidence: 93%

European* clinical practice recommendations on opioids for chronic noncancer pain – Part 1: Role of opioids in the management of chronic noncancer pain

Haüser

Morlion

Vowles

et al. 2021

European Journal of Pain

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Section: Publication and Disseminationsupporting

confidence: 93%

European* clinical practice recommendations on opioids for chronic noncancer pain – Part 1: Role of opioids in the management of chronic noncancer pain

Haüser

Morlion

Vowles

et al. 2021

European Journal of Pain

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“…Among numerous drugs used for HPI-related diseases many are well known to contribute to OP/OFs. In regard to OP, these include corticosteroids, antidepressants (especially, selective serotonin- and serotonin-norepinephrine reuptake inhibitors), glitazones, opioids, benzodiazepines, antipsychotics, antiparkinsonian drugs, antiepileptics, PPIs, H2RA, thyroxine, furosemide, aromatase inhibitors, gonadotropin releasing hormone (GnRH) agonists, whereas hormone replacement therapy with estrogen, thiazides, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), spironolactone, beta-blockers, statins, antihistamines, metformin, sulphonylureas, glucagon-like peptide-1 receptor agonists (liraglutide) and nitrates have shown an osteoprotective effect [ 316 , 521 , 522 , 523 , 524 , 525 , 526 , 527 , 528 , 529 , 530 , 531 , 532 , 533 , 534 , 535 , 536 , 537 , 538 , 539 , 540 , 541 , 542 , 543 , 544 , 545 , 546 , 547 , 548 , 549 , 550 , 551 , 552 , 553 , 554 ].…”

Section: Hpi-associated Chronic Extra-gastroduodenal Diseases Medmentioning

confidence: 99%

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

Fisher

Smith

2020

JCM

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Osteoporosis (OP) and osteoporotic fractures (OFs) are common multifactorial and heterogenic disorders of increasing incidence. Helicobacter pylori (H.p.) colonizes the stomach approximately in half of the world’s population, causes gastroduodenal diseases and is prevalent in numerous extra-digestive diseases known to be associated with OP/OF. The studies regarding relationship between H.p. infection (HPI) and OP/OFs are inconsistent. The current review summarizes the relevant literature on the potential role of HPI in OP, falls and OFs and highlights the reasons for controversies in the publications. In the first section, after a brief overview of HPI biological features, we analyze the studies evaluating the association of HPI and bone status. The second part includes data on the prevalence of OP/OFs in HPI-induced gastroduodenal diseases (peptic ulcer, chronic/atrophic gastritis and cancer) and the effects of acid-suppressive drugs. In the next section, we discuss the possible contribution of HPI-associated extra-digestive diseases and medications to OP/OF, focusing on conditions affecting both bone homeostasis and predisposing to falls. In the last section, we describe clinical implications of accumulated data on HPI as a co-factor of OP/OF and present a feasible five-step algorithm for OP/OF risk assessment and management in regard to HPI, emphasizing the importance of an integrative (but differentiated) holistic approach. Increased awareness about the consequences of HPI linked to OP/OF can aid early detection and management. Further research on the HPI–OP/OF relationship is needed to close current knowledge gaps and improve clinical management of both OP/OF and HPI-related disorders.

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“…For instance, numerous individuals who suffer from chronic pain experience depression, anxiety and even suicidal thoughts ( 3 ). Opiates, which were discovered thousands of years ago, are to date the most common and effective analgesics for the treatment of pain and pain-associated disorders ( 4 ). Important progress has been made in the development of opioids derived from opiates in the last century, but several of their side effects persist ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Molecular mechanisms of opioid tolerance: From opioid receptors to inflammatory mediators (Review)

Zhou

Ying

et al. 2021

Exp Ther Med

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Opioids are considered the most effective analgesics for the treatment of both acute and chronic pain. However, prolonged opioid use can induce a certain level of tolerance to its analgesic effects, leading to a reduction in its effectiveness, addiction and abuse. A better understanding of the mechanisms underlying opioid tolerance may provide insights into this phenomenon and aid in the development of novel methods to combat the side effects of opioid tolerance. The present review focused on two major contributors to tolerance, opioid receptors and inflammatory mediators. The molecular mechanisms involved in the desensitization of the opioid receptors were briefly described, including their phosphorylation, internalisation and recycling. Subsequently, the effects of Toll like receptor 4/NOD-like receptor family pyrin domain containing 3-mediated proinflammatory responses in opioid tolerance were discussed, aiming in supporting the identification of novel therapeutic targets. Contents 1. Introduction 2. Opioid receptors 3. Molecular mechanisms of opioid tolerance 4. Proinflammatory cytokines in morphine tolerance 5. Conclusions

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Opioid Treatments for Chronic Pain

Cited by 76 publications

References 0 publications

European* clinical practice recommendations on opioids for chronic noncancer pain – Part 1: Role of opioids in the management of chronic noncancer pain

European* clinical practice recommendations on opioids for chronic noncancer pain – Part 1: Role of opioids in the management of chronic noncancer pain

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

Molecular mechanisms of opioid tolerance: From opioid receptors to inflammatory mediators (Review)

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