The Dueling Obligations of Opioid Stewardship
Authors: Phillip Coffin, Caleb Banta-Green
Journal: Annals of Internal Medicine (2014)

Letters19 August 2014The Dueling Obligations of Opioid StewardshipPhillip Coffin, MD, MIA and Caleb Banta-Green, PhDPhillip Coffin, MD, MIAFrom San Francisco Department of Public Health, San Francisco, California; and University of Washington, Seattle Washington.Search for more papers by this author and Caleb Banta-Green, PhDFrom San Francisco Department of Public Health, San Francisco, California; and University of Washington, Seattle Washington.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5016-8 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree that data are insufficient to support or refute the potential benefits of long-term opioid use for chronic, nonmalignant pain. However, evidence of harm is not lacking. We will refrain from repeating the findings of the referenced American College of Physicians policy statement. Instead, we will emphasize the growing literature that has questioned the potential benefits of long-term opioid therapy in this context and raised serious concerns about unintended adverse consequences at population and individual levels.In 2012, an estimated 4.8 million persons had used prescription pain relievers for nonmedical purposes in the past month and 1.9 ...References1. Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: summary of national findings. NSDUH Series H-41, HHS publication no. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013. Google Scholar2. Peavy KM, Banta-Green CJ, Kingston S, Hanrahan M, Merrill JO, Coffin PO. “Hooked on” prescription-type opiates prior to using heroin: results from a survey of syringe exchange clients. J Psychoactive Drugs. 2012;44:259-65. [PMID: 23061326] CrossrefMedlineGoogle Scholar3. Martell BA, O'Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Ann Intern Med. 2007;146:116-27. [PMID: 17227935] LinkGoogle Scholar4. Levin M. Opioids in headache. Headache. 2014;54:12-21. [PMID: 24127913] doi:10.1111/head.12266 CrossrefMedlineGoogle Scholar5. Skaer TL. Fibromyalgia: disease synopsis, medication cost effectiveness and economic burden. Pharmacoeconomics. 2014;32:457-66. [PMID: 24504852] doi:10.1007/s40273-014-0137-y CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From San Francisco Department of Public Health, San Francisco, California; and University of Washington, Seattle Washington.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2781. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Dueling Obligations of Opioid Stewardship Phillip Coffin and Caleb Banta-Green The Dueling Obligations of Opioid Stewardship William M. Tierney The Dueling Obligations of Opioid Stewardship William M. Tierney Metrics Cited ByOpioids, naloxone, and beyond: The intersection of medication safety, public health, and pharmacyNon-medical use of prescription pain medications and increased emergency department utilization: Results of a national survey 19 August 2014Volume 161, Issue 4Page: 307-308KeywordsDeath ratesDisclosureFibromyalgiaHeadachesHeroinLegislationLower back painOpioidsSystematic reviews ePublished: 19 August 2014 Issue Published: 19 August 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...