Effectiveness of Opioid Analgesics in Chronic Noncancer Pain

Pain Practice ◽  
2014 ◽  
Vol 15 (3) ◽  
pp. 272-278 ◽  
Author(s):  
Renata Ferrari ◽  
Maria E. Zanolin ◽  
Genni Duse ◽  
Marco Visentin
Keyword(s):  
Opioid Analgesics ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

Racial Differences in Prescription of Opioid Analgesics for Chronic Noncancer Pain in a National Sample of Veterans

2014 ◽  
Vol 15 (4) ◽  
pp. 447-455 ◽  
Author(s):  
Diana J. Burgess ◽  
David B. Nelson ◽  
Amy A. Gravely ◽  
Matthew J. Bair ◽  
Robert D. Kerns ◽  
...  
Keyword(s):  
Racial Differences ◽  
Opioid Analgesics ◽  
National Sample ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

scholarly journals Abuse-deterrent formulations of prescription opioid analgesics in the management of chronic noncancer pain

2016 ◽  
Vol 6 (5) ◽  
pp. 497-508 ◽  
Author(s):  
Martin E Hale ◽  
Derek Moe ◽  
Mary Bond ◽  
Maciej Gasior ◽  
Richard Malamut
Keyword(s):  
Opioid Analgesics ◽  
Prescription Opioid ◽  
Chronic Noncancer Pain ◽  
Prescription Opioid Analgesics ◽  
Noncancer Pain

scholarly journals The chronic need to improve the management of pain

2003 ◽  
Vol 8 (4) ◽  
pp. 187-188 ◽  
Author(s):  
Eldon Tunks
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Opioid Analgesics ◽  
Care Practice ◽  
Eligibility Criteria ◽  
Chronic Noncancer Pain ◽  
Primary Care Doctors ◽  
Third Line ◽  
Noncancer Pain

In this issue, Drs Morley-Forster, Clark, Speechley and Moulin report on their survey conducted by Ipsos-Reid in June 2001 (pages 189-194). Only physicians who met the eligibility criteria of having written 20 or more prescriptions for moderate to severe pain in the preceding four weeks or having devoted 20% of their time to palliative care were eligible to participate. Sixty-eight per cent of the respondents thought that moderate to severe chronic pain was not well managed in Canada. Despite this opinion, 23% of physicians in palliative care practice and 34% of primary care doctors stated that they would not use opioids to treat moderate to severe chronic noncancer pain even as a third-line treatment after two previous medications had failed. One-quarter to one-third were concerned about the potential for addiction, and a smaller percentage reported concern about the potential for patient abuse and/or misuse, and side effects. Fear of a College audit resulting in the loss of their medical licence was cited by 10% of primary care physicians. When asked what obstacle hindered their use of strong opioid analgesics, an unexplained 10% of palliative care doctors and 14% of primary care doctors answered "nothing in particular".

scholarly journals Chronic Pain in Canada - Prevalence, Treatment, Impact and the Role of Opioid Analgesia

2002 ◽  
Vol 7 (4) ◽  
pp. 179-184 ◽  
Author(s):  
Dwight E Moulin ◽  
Alexander J Clark ◽  
Mark Speechley ◽  
Patricia K Morley-Forster
Keyword(s):  
Chronic Pain ◽  
Economic Impact ◽  
Severe Pain ◽  
Census Data ◽  
Multidisciplinary Treatment ◽  
Opioid Analgesics ◽  
Prescription Medication ◽  
Average Intensity ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

OBJECTIVE:To assess the prevalence, treatment and impact of chronic pain in Canada.METHODS:A stratified random sample of 2012 adult Canadians (weighted by sex, age and region according to 1996 census data) was surveyed by telephone in 2001 to determine the prevalence of chronic pain, defined as continuous or intermittent pain for at least six months. A second sample of 340 chronic pain sufferers who were taking prescription medication for their pain was studied in detail to determine current therapeutic approaches and to assess the social and economic impact of chronic pain.RESULTS:Chronic noncancer pain was reported by 29% of the respondents, with increased frequency in women and older age groups. The average duration of pain was 10.7 years and the average intensity was 6.3 (on a scale from 1 to 10), with 80% reporting moderate or severe pain. Anti-inflammatory agents were prescribed for 49% of respondents and opioid analgesics were prescribed for 22% (two-thirds of these were codeine). Almost 70% were worried about addiction potential, and one-third felt that strong analgesics should be reserved for terminal illnesses. Almost one-half were unable to attend social and family events, and the mean number of days absent from work in the past year due to chronic pain was 9.3.INTERPRETATION:Chronic noncancer pain is common in Canadian adults and has a major social and economic impact. Despite growing evidence supporting the efficacy and safety of major opioid analgesics for chronic noncancer pain, less than 10% of chronic pain patients taking prescription medication were treated with a major opioid. Chronic pain is undertreated in Canada, and major opioid analgesics are probably underutilized in the management of moderate to severe pain as part of a multidisciplinary treatment program.

scholarly journals Use of Opioid Analgesics for the Treatment of Chronic Noncancer Pain - A Consensus Statement and Guidelines from the Canadian Pain Society, 2002

2003 ◽  
Vol 8 (suppl a) ◽  
pp. 3A-14A ◽  
Author(s):  
Roman D Jovey ◽  
Jeffrey Ennis ◽  
Jacqueline Gardner-Nix ◽  
Brian Goldman ◽  
Helen Hays ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Opioid Analgesics ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

scholarly journals Efficacy and Abuse Potential of Opioid Analgesics and the Treatment of Chronic Noncancer Pain

1999 ◽  
Vol 4 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Andrew C Darke ◽  
John H Stewart
Keyword(s):  
Clinical Trials ◽  
Physical Dependence ◽  
Opioid Analgesics ◽  
Controlled Clinical Trials ◽  
Appropriate Use ◽  
Chronic Noncancer Pain ◽  
Prescribe Opioid ◽  
Noncancer Pain ◽  
Made In

While the role of opioid analgesics has been established in the treatment of cancer pain, reservations persist about appropriate use in patients with chronic noncancer pain. Recent evidence from controlled clinical trials supports the effectiveness of opioids for treating noncancer pain of varying etiologies. The safety of opioids in noncancer patients has been an area of controversy because of confusion between physical dependence, which develops in all patients receiving opioids chronically, and addiction, which is a behavioural diagnosis that is rarely made in patients appropriately treated with opioids for pain. Abuse by secondary recipients of opioids is well documented and arises as a result of diversion by primary recipients, double-doctoring, forgery and theft. The frequency of forgery and theft of different opioids appears to be largely related to the corresponding number of legitimate prescriptions. While it is legitimate medical practice to prescribe opioid analgesics to patients with chronic noncancer pain, there is clear evidence that prescribing is affected by concerns of regulatory sanctions. Recent guidelines, including most recently comprehensive guidelines issued by the Canadian Pain Society, should help to reduce inappropriate undertreatment because of such concerns.

scholarly journals Pain Relief, Prescription Drugs, and Prosecution: A Four-State Survey of Chief Prosecutors

2003 ◽  
Vol 31 (1) ◽  
pp. 75-100 ◽  
Author(s):  
Stephen J. Ziegler ◽  
Nicholas P. Lovrich
Keyword(s):  
Pain Management ◽  
Prescription Drugs ◽  
Management Practices ◽  
Opioid Analgesics ◽  
The United States ◽  
Regulatory Environment ◽  
Criminal Prosecution ◽  
Chronic Noncancer Pain ◽  
Regulatory Scrutiny ◽  
Noncancer Pain

The experience of having to suffer debilitating pain is far too common in the United States, and many patients continue to be inadequately treated by their doctors. Although many physicians freely admit that their pain management practices may have been somewhat lacking, many more express concern that the prescribing of heightened levels of opioid analgesics may result in closer regulatory scrutiny, criminal investigation, or even criminal prosecution.Although several researchers have examined the regulatory environment and the threat of sanction or harm it poses to physicians and patients, few have examined the likelihood of investigation or prosecution stemming from the aggressive use of opioids in physician-directed pain management. Accordingly, in an effort to assess whether the fear of prosecution is realistic and, if so, what factors contribute to its likelihood, we surveyed chief prosecutors in four states about their knowledge, opinions, and attitudes concerning opioids and the prosecution of physicians stemming from the treatment of patients who were either terminally ill or suffering from chronic noncancer pain.

scholarly journals A Survey of Chronic Noncancer Pain Patients Prescribed Opioid Analgesics

Pain Medicine ◽  
2003 ◽  
Vol 4 (4) ◽  
pp. 340-351 ◽  
Author(s):  
David T. Cowan ◽  
Jenifer Wilson-Barnett ◽  
Peter Griffiths ◽  
Laurie G. Allan
Keyword(s):  
Opioid Analgesics ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain ◽  
Pain Patients
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