Who Benefits from Chronic Opioid Therapy? Rethinking the Question of Opioid Misuse Risk

Healthcare

Carl E. Noe¹  Olivia Van Ness¹  Richard C. Robinson¹  Elizabeth Huber¹ 

[1] The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390, USA;

关键词: chronic pain;    chronic low back pain;    opioids;    chronic opioid therapy;    biopsychosocial approach;   

DOI  :  10.3390/healthcare4020029

来源: DOAJ

【 摘 要 】

Beginning in the late 1990s, a movement began within the pain management field focused upon the underutilization of opioids, thought to be a potentially safe and effective class of pain medication. Concern for addiction and misuse were present at the start of this shift within pain medicine, and an emphasis was placed on developing reliable and valid methods and measures of identifying those at risk for opioid misuse. Since that time, the evidence for the safety and effectiveness of chronic opioid therapy (COT) has not been established. Rather, the harmful, dose-dependent deleterious effects have become clearer, including addiction, increased risk of injuries, respiratory depression, opioid induced hyperalgesia, and death. Still, many individuals on low doses of opioids for long periods of time appear to have good pain control and retain social and occupational functioning. Therefore, we propose that the question, “Who is at risk of opioid misuse?” should evolve to, “Who may benefit from COT?” in light of the current evidence.

【 授权许可】

Unknown