The Effectiveness and Risks of Long-Term Opioid Therapy for Chronic Pain: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop

Abstract

Agency for Healthcare Research and Quality.

Association Between Initial Opioid Prescribing Patterns and Subsequent Long-Term Use Among Opioid-Naïve Patients: A Statewide Retrospective Cohort Study

“…We did not try to identify or define dependency, misuse, abuse, or addiction, though these in turn are associated with long-term use. [5][6][7][8]10 Analysis. Chi-square and related tests for trend were used to compare demographic features of patients who did or did not initiate long-term opioid use.…”

“…4 For non-cancer conditions, long-term use is problematic because of substantial rates of dependence and misuse, and because efficacy of long-term therapy remains unproven. [5][6][7][8] Emergence of drug tolerance and hyperalgesia may limit long-term efficacy. 9 Several factors may explain the emergence of inadvertent longterm use, including opioid dependence, non-medical use, substance use disorders, and diversion to other users.…”

Mindfulness Meditation for Chronic Pain: A Systematic Review

“…Any errors of fact or interpretation in this report remain the responsibility of the authors. Chronic pain, often defined as pain lasting longer than three months or past the normal time for tissue healing (Chou et al, 2015), can lead to significant medical, social, and economic consequences; relationship issues; lost productivity; and larger health care costs. Further, chronic pain is frequently accompanied by psychiatric disorders, such as pain medication addiction, depression, and anxiety, that make treatment complicated (Management of Opioid Therapy for Chronic Pain Working Group, 2010).…”

Capsule Commentary on Gaither et al., the Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality

“…3 This makes the use of alternatives all that more attractive, considering that the evidence for dose-related serious harm is much stronger than the evidence of longer-term effectiveness. 4 Larger, more potentially integrated health systems such as the Veteran's Administration may have greater capacity to more adequately deliver multimodal care. Both graded exercise and cognitive-behavioral therapy have very strong evidence bases for use in chronic pain.…”