Buprenorphine for Long-Term Chronic Pain Management: Still Looking for the Evidence
Authors: Michael E. Schatman, Hannah Shapiro, David J. DiBenedetto
Journal: Annals of Internal Medicine (2020)

Letters18 February 2020Buprenorphine for Long-Term Chronic Pain Management: Still Looking for the EvidenceMichael E. Schatman, PhD, Hannah Shapiro, and David J. DiBenedetto, MDMichael E. Schatman, PhDBoston PainCare, Tufts University School of Dental Medicine, and Tufts University School of Medicine, Waltham and Boston, Massachusetts (M.E.S.)Search for more papers by this author, Hannah ShapiroTufts University, Medford, Massachusetts (H.S.)Search for more papers by this author, and David J. DiBenedetto, MDBoston PainCare and Tufts University School of Dental Medicine, Waltham and Boston, Massachusetts (D.J.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0683 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In regard to the recent article on opioid tapering by Chou and colleagues (1), we would like to commend the authors for advocating a relatively patient-centered approach to this process, in which they have stressed such crucial issues as the imperatives of compassion and individualization of tapering protocols. Despite the Centers for Disease Control and Prevention's recent claim that its 2016 guideline was “misapplied” and warnings against “policies that encourage hard limits and abrupt tapering of drug dosages” (2), no evidence to date has suggested that such tapers are on a decline.Although well intentioned, the authors' ...References1. Chou R, Ballantyne J, Lembke A. Rethinking opioid dose tapering, prescription opioid dependence, and indications for buprenorphine. Ann Intern Med. 2019;171:427-9. [PMID: 31450240]. doi:10.7326/M19-1488 LinkGoogle Scholar2. Dowell D, Haegerich T, Chou R. No shortcuts to safer opioid prescribing. N Engl J Med. 2019;380:2285-2287. [PMID: 31018066] doi:10.1056/NEJMp1904190 CrossrefMedlineGoogle Scholar3. Gowing L, Ali R, White JM, et al. Buprenorphine for managing opioid withdrawal. Cochrane Database Syst Rev. 2017;2:CD002025. [PMID: 28220474] doi:10.1002/14651858.CD002025.pub5 CrossrefMedlineGoogle Scholar4. Ronquest NA, Willson TM, Montejano LB, et al. Relationship between buprenorphine adherence and relapse, health care utilization and costs in privately and publicly insured patients with opioid use disorder. Subst Abuse Rehabil. 2018;9:59-78. [PMID: 30310349] doi:10.2147/SAR.S150253 CrossrefMedlineGoogle Scholar5. Macey TA, Weimer MB, Grimaldi EM, et al. Patterns of care and side effects for patients prescribed methadone for treatment of chronic pain. J Opioid Manag. 2013 Sep-Oct;9:325-33. [PMID: 24353045] doi:10.5055/jom.2013.0175 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Boston PainCare, Tufts University School of Dental Medicine, and Tufts University School of Medicine, Waltham and Boston, Massachusetts (M.E.S.)Tufts University, Medford, Massachusetts (H.S.)Boston PainCare and Tufts University School of Dental Medicine, Waltham and Boston, Massachusetts (D.J.D.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0683. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRethinking Opioid Dose Tapering, Prescription Opioid Dependence, and Indications for Buprenorphine Roger Chou , Jane Ballantyne , and Anna Lembke Buprenorphine for Long-Term Chronic Pain Management: Still Looking for the Evidence Roger Chou , Jane Ballantyne , and Anna Lembke Metrics 18 February 2020Volume 172, Issue 4Page: 293-294KeywordsAnalgesicsClinical trialsDisclosureDrug policyDrug regulationDrugsOpioid addictionOpioidsPain managementScientists ePublished: 18 February 2020 Issue Published: 18 February 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...