Long-Term Opioid Therapy for Chronic Pain
Authors: Roger Chou
Journal: Annals of Internal Medicine (2015)

Letters21 July 2015Long-Term Opioid Therapy for Chronic PainRoger Chou, MDRoger Chou, MDFrom Oregon Health & Science University, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5109-3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Lubrano and colleagues that effectively managing the risks of prescribing long-term opioid therapy will not be based just on evidence about benefits and harms (the subject of our review) but will also require that clinicians and policymakers understand and address policy and factors related to the physician–patient interaction that may drive less appropriate prescribing practices (1).As Dr. Retan notes, we identified no studies meeting predefined inclusion criteria on the effectiveness of long-term opioid therapy for chronic pain. He does not describe any studies that we overlooked. Therefore, it is unclear what evidence he ...References1. Reuben DB, Alvanzo AA, Ashikaga T, Bogat GA, Callahan CM, Ruffing V, et al. National Institutes of Health Pathways to Prevention Workshop: the role of opioids in the treatment of chronic pain. Ann Intern Med. 2015;162:295-300. [PMID: 25581341] doi:10.7326/M14-2775 LinkGoogle Scholar2. Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152:85-92. [PMID: 20083827] doi:10.7326/0003-4819-152-2-201001190-00006 LinkGoogle Scholar3. Gomes T, Mamdani MM, Dhalla IA, Paterson JM, Juurlink DN. Opioid dose and drug-related mortality in patients with nonmalignant pain. Arch Intern Med. 2011;171:686-91. [PMID: 21482846] doi:10.1001/archinternmed.2011.117 CrossrefMedlineGoogle Scholar4. Deyo RA, Smith DH, Johnson ES, Tillotson CJ, Donovan M, Yang X, et al. Prescription opioids for back pain and use of medications for erectile dysfunction. Spine (Phila Pa 1976). 2013;38:909-15. [PMID: 23459134] doi:10.1097/BRS.0b013e3182830482 CrossrefMedlineGoogle Scholar5. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010;363:1981-5. [PMID: 21083382] doi:10.1056/NEJMp1011512 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Oregon Health & Science University, Portland, Oregon.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2559. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Effectiveness and Risks of Long-Term Opioid Therapy for Chronic Pain: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop Roger Chou , Judith A. Turner , Emily B. Devine , Ryan N. Hansen , Sean D. Sullivan , Ian Blazina , Tracy Dana , Christina Bougatsos , and Richard A. Deyo 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 Roger Chou , Judith A. Turner , Emily B. Devine , Ryan N. Hansen , Sean D. Sullivan , Ian Blazina , Tracy Dana , Christina Bougatsos , and Richard A. Deyo Long-Term Opioid Therapy for Chronic Pain Michael Lubrano , Jonathan P. Wanderer , and Jesse M. Ehrenfeld Long-Term Opioid Therapy for Chronic Pain J. Walden Retan Long-Term Opioid Therapy for Chronic Pain J. Walden Retan Long-Term Opioid Therapy for Chronic Pain Michael Lubrano , Jonathan P. Wanderer , and Jesse M. Ehrenfeld Metrics Cited ByThoughts on the 2019 American Academy of Sleep Medicine position statement on chronic opioid therapy and sleepOpioid Use in Long-Term Care: Guidelines and Policy Recommendations 21 July 2015Volume 163, Issue 2Page: 148KeywordsAdverse eventsAlcohol consumptionDisclosureErectile dysfunctionMyocardial infarctionOpioidsSuicideTestosterone ePublished: 21 July 2015 Issue Published: 21 July 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...