Use of Opioids in Management of Chronic Noncancer Pain
Authors: A. Thomas McLellan
Journal: Annals of Internal Medicine (2010)

Letters1 June 2010Use of Opioids in Management of Chronic Noncancer PainA. Thomas McLellan, MD and Barbara J. Turner, MD, MSED, Executive Deputy EditorA. Thomas McLellan, MDFrom White House Office of National Drug Control Policy, Washington DC 20503, and Executive Deputy Editor.Search for more papers by this author and Barbara J. Turner, MD, MSED, Executive Deputy EditorFrom White House Office of National Drug Control Policy, Washington DC 20503, and Executive Deputy Editor.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-11-201006010-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The remarks from Dr. Gelfand and Dr. Kornfeld exemplify the wide spectrum of opinions about the use of opioids for chronic noncancer pain. Dr. Gelfand questions the use of these drugs in persons with mental health disorders, and Dr. Kornfeld takes issue with our suggestion that high-dose opioids should be avoided. However, Dr. Gelfand accurately emphasizes the high prevalence of comorbid mental health disorders in persons prescribed opioids. In a national population-based community survey (1), persons with a history of mood disorder (such as depression and anxiety disorder) were more than 4 times more likely than persons without ...References1. Sullivan MD, Edlund MJ, Zhang L, Unützer J, Wells KB. Association between mental health disorders, problem drug use, and regular prescription opioid use. Arch Intern Med. 2006;166:2087-93. [PMID: 17060538] CrossrefMedlineGoogle 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] LinkGoogle Scholar3. Chou R, Fanciullo GJ, Fine PG, Miaskowski C, Passik SD, Portenoy RK. Opioids for chronic noncancer pain: prediction and identification of aberrant drug-related behaviors: a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10:131-46. [PMID: 19187890] CrossrefMedlineGoogle Scholar4. Chou R, Ballantyne JC, Fanciullo GJ, Fine PG, Miaskowski C. Research gaps on use of opioids for chronic noncancer pain: findings from a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10:147-59. [PMID: 19187891] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From White House Office of National Drug Control Policy, Washington DC 20503, and Executive Deputy Editor.Note: The opinions expressed here do not necessarily represent those of the White House Office of National Drug Control Policy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChronic Noncancer Pain Management and Opioid Overdose: Time to Change Prescribing Practices A. Thomas McLellan and Barbara J. Turner Opioid Prescriptions for Chronic Pain and Overdose Kate M. Dunn , Kathleen W. Saunders , Carolyn M. Rutter , Caleb J. Banta-Green , Joseph O. Merrill , Mark D. Sullivan , Constance M. Weisner , Michael J. Silverberg , Cynthia I. Campbell , Bruce M. Psaty , and Michael Von Korff Opioids in Management of Chronic Noncancer Pain Stephen G. Gelfand Use of Opioids in Management of Chronic Noncancer Pain Howard Kornfeld Use of Opioids in Management of Chronic Noncancer Pain Marcus M. Reidenberg Metrics 1 June 2010Volume 152, Issue 11Page: 757-758KeywordsCancer treatmentDrug regulationDrugsMental health therapiesMood disordersMorphineOpioidsOral healthPain managementPsychiatry and mental health ePublished: 1 June 2010 Issue Published: 1 June 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...