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Am J Med. 2012 Dec;125(12):1155-61. doi: 10.1016/j.amjmed.2012.04.032. Epub 2012 Aug 31.

Opioids for the treatment of chronic noncancer pain.

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  • 1Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA. ewarner@health.usf.edu

Abstract

Increasingly, opioids are used to treat chronic noncancer pain. While opioids are well recognized for their effectiveness in treating acute pain, the evidence supporting the benefits for the treatment of chronic pain is less well established. Improvement of both pain and function should be considered goals of therapy. Patients with chronic pain have a higher incidence of preexisting psychological disorders. Adverse effects of opioid therapy include dependence, overdose, and withdrawal. Risk factors for poor outcomes with opioid therapy are identified, and include preexisting mental illness and dose prescribed. Recommended strategies to more safely use opioids are discussed, including tools for identifying high-risk patients. The evidence supporting the use of treatment agreements and urine drug testing to reduce the effects of adverse outcomes is limited.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:
22944349
[PubMed - indexed for MEDLINE]
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