Opioid Prescriptions for Chronic Pain and Overdose
Annals of Internal MedicinePublished 19 January 2010
Kate M. Dunn, Kathleen W. Saunders, Carolyn M. Rutter, Caleb J. Banta-Green, Joseph O. Merrill, Mark D. Sullivan
Citations1,246
SJR quartileQ1
SJR score3.38
SNIP3.27
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Patients receiving higher doses of prescribed opioids are at increased risk for overdose, which underscores the need for close supervision of these patients.
Abstract
National Institute of Drug Abuse.
Keywords
Medicine
Statistics in the health sciencesModeling Survival Data: Extending the Cox Model
8,662 Citations2000Terry M. Therneau, Patricia M. Grambsch
A Cox Model-based approach was used to estimate the Survival and Hazard Functions and the results confirmed the need for further investigation into the role of natural disasters in shaping survival rates.
BiometrikaProportional hazards tests and diagnostics based on weighted residuals
5,601 Citations1994Patricia M. Grambsch, Terry M. Therneau
Journal of PainClinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
2,206 Citations2009Roger Chou, Gilbert J. Fanciullo +19 more
Safe and effective chronic opioid therapy for chronic noncancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and on the assessment and management of risks associated with opioid abuse, addiction, and diversion.
New England Journal of MedicineOpioid Therapy for Chronic Pain
957 Citations2003Jane C. Ballantyne, Jianren Mao
This review addresses specific questions about dose and toxicity in the light of recent studies that suggest a need to modify current practices in the use of opioid therapy for chronic pain.
Canadian Medical Association JournalOpioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects
878 Citations2006Andrea D Furlan
Weak and strong opioids outperformed placebo for pain and function in all types of CNCP and were significantly superior to naproxen and nortriptyline, and only for pain relief.
JAMAPatterns of Abuse Among Unintentional Pharmaceutical Overdose Fatalities
817 Citations2008Aron J. Hall
The majority of overdose deaths in West Virginia in 2006 were associated with nonmedical use and diversion of pharmaceuticals, primarily opioid analgesics.
Annals of Internal MedicineSystematic Review: Opioid Treatment for Chronic Back Pain: Prevalence, Efficacy, and Association with Addiction
787 Citations2007Bridget Martell, Patrick G. O’Connor +5 more
This systematic review and meta-analysis addresses the following questions: Are opioid medications effective in treating chronic back pain?
Pharmacoepidemiology and Drug SafetyIncreasing deaths from opioid analgesics in the United States
700 Citations2006Leonard J. Paulozzi, Daniel S. Budnitz +1 more
A dramatic increase in poisoning mortality rates is documented and the use of opioid analgesics has increased markedly as part of more aggressive pain management nationwide and this study compared it to sales of opioids nationwide.
Clinical Journal of PainDe Facto Long-term Opioid Therapy for Noncancer Pain
656 Citations2008Michael Von Korff, Kathleen Saunders +9 more
The proposed threshold for long-term opioid therapy provides a checkpoint for physicians to review whether an explicit decision to sustain opioid therapy has been reached, and to ensure that a documented treatment plan and provisions for monitoring medication use and patient outcomes are in place.
Pharmacoepidemiology and Drug SafetyTrends in long‐term opioid therapy for chronic non‐cancer pain
538 Citations2009Denise M. Boudreau, Michael Von Korff +9 more
To report trends and characteristics of long‐term opioid use for non‐cancer pain for non-cancer pain, a large number of patients with a history of abuse or dependence are surveyed for the first time.
PainCritical issues on opioids in chronic non-cancer pain:
509 Citations2006Jørgen Eriksen, Per Sjøgren +3 more
It is remarkable that opioid treatment of long‐term/chronic non‐cancer pain does not seem to fulfil any of the key outcome opioid treatment goals: pain relief, improved quality of life and improved functional capacity.
Pain PhysicianOpioids in the Management of ChronicNon-Cancer Pain: An Update of AmericanSociety of the Interventional Pain Physicians’(ASIPP) Guidelines
436 Citations2008Laxmaiah Manchikanti
The evidence for the effectiveness of long-term opioids in reducing pain and improving functional status for 6 months or longer is variable and the recommendation is 2A - weak recommendation, high-quality evidence: with benefits closely balanced with risks and burdens.
PainOffice visits and analgesic prescriptions for musculoskeletal pain in US: 1980 vs. 2000
368 Citations2004Margaret Caudill-Slosberg, Lisa M. Schwartz +1 more
In spite of the increased attention to pain treatment, there has not been an increase in office visits for musculoskeletal pain complaints and the threshold for prescribing NSAIDS and opioids, however, has dropped.
Clinical Journal of PainEfficacy of Opioids for Chronic Pain
364 Citations2008Jane C. Ballantyne, Naomi S. Shin
It is concluded that existing evidence suggests that analgesic efficacy, although initially good, is not always sustained during continuous and long-term opioid therapy (months to years).
Medical CareRisk Adjustment Using Automated Ambulatory Pharmacy Data
336 Citations2003Paul Fishman, Michael J. Goodman +4 more
HCCs produce more accurate forecasts of total cost, but the pharmacy-based RxRisk is an alternative risk assessment instrument to several diagnostic based models and depending on the nature of the application may be a more appropriate option for medical risk analysis.
SpineRelationship Between Early Opioid Prescribing for Acute Occupational Low Back Pain and Disability Duration, Medical Costs, Subsequent Surgery and Late Opioid Use
327 Citations2007Barbara S. Webster, Santosh K. Verma +1 more
American Journal of Preventive MedicineOpioid Analgesics and Rates of Fatal Drug Poisoning in the United States
280 Citations2006Leonard J. Paulozzi, Grace Ryan
Variation in the availability of opioid analgesics is related to the spatial distribution of drug poisoning mortality by state and a scatterplot demonstrated a linear relationship between total opioid analgesic sales andDrug poisoning mortality.
American Journal of Industrial MedicineOpioid dosing trends and mortality in Washington State workers' compensation, 1996-2002
159 Citations2005Gary M. Franklin, Jaymie Mai +4 more
Opioid-related deaths in this population may be preventable through use of prudent guidelines regarding opioid use for chronic pain, and it is possible that tolerance or opioid-induced abnormal pain sensitivity may be occurring in some workers who use opioids for chronicPain.
PubMedOpioid analgesia: perspectives on right use and utility.
158 Citations2007Jane C. Ballantyne
What evidence supports the long-term utility of opioids for chronic pain; how side effects may alter quality of life; 3) the nature of addiction and why it is different in pain patients, and 4) on what grounds could pain medication be denied?
Pain PhysicianOpioid Analgesia: Perspectives onRight Use and Utility
143 Citations2007Jane C. Ballantyne
AddictionUnintentional drug overdose death trends in New Mexico, USA, 1990–2005: combinations of heroin, cocaine, prescription opioids and alcohol
125 Citations2007Nina Shah, Sarah Lathrop +2 more
Interventions to prevent drug overdose death should be targeted according to use patterns among at-risk subpopulations, and a comprehensive approach addressing both illicit and prescription drug users, and people who use these drugs concurrently, is needed.
JAMAPrescription Opioids, Overdose Deaths, and Physician Responsibility
113 Citations2008A. Thomas McLellan
Findings raise questions about physician prescribing practices, safety and effectiveness of medications, and the appropriate man-agement of pain in patients and their obliga-tion to prevent the broader public health problems of ad-diction and overdose death.
PainPotent opioids for chronic musculoskeletal pain: flying blind?
108 Citations2004Michael Von Korff, Richard A. Deyo
There is a marked increase in use of potent opioids for management of chronic musculoskeletal pain in US (Caudill-Slosberg et al.), increasing from 2% of chronic pain visits in 1980 to 9% in 2000.
The Journals of Gerontology Series ALong-Term Effects of Analgesics in a Population of Elderly Nursing Home Residents With Persistent Nonmalignant Pain
89 Citations2006Aida Won, Kate L. Lapane +4 more
The use of long-acting opioids may be a relatively safe option in the management of persistent nonmalignant pain in the nursing home population, yielding benefits in functional status and social engagement.
European Journal of PainOpioids in chronic non‐cancer pain, indications and controversies
82 Citations2004Harald Breivik
The outlook for successful long term opioid therapy is better in a patient with a stable psychossocial situation having nociceptive type pain that is markedly relieved by a moderate dose of a long lasting oral or transdermal opioid, than a patient from a complex and unstable psychosocial background having neuropathic type pain.
Drug SafetySurveillance of Prescription Drug-Related Mortality Using Death Certificate Data
81 Citations2007Diane K. Wysowski
Dealing with overdoses are the most prominent cause of drug-related mortality in death certificate data, and certain drugs and drug classes, especially the opioids, are associated with large and increasing numbers of deaths and preventive strategies should be considered.
Annals of PharmacotherapyRates of Adverse Events of Long-Acting Opioids in a State Medicaid Program
65 Citations2007Daniel M. Hartung, Luke Middleton +4 more
A modest safety advantage is supported with ER oxycodone compared with ER morphine among patients newly prescribed an LAO and among subjects with noncancer pain, fentanyl and methadone were associated with an increased risk of an adverse event compared withER morphine.
Clinical Pharmacology & TherapeuticsProsecution of Physicians for Prescribing Opioids to Patients
37 Citations2007M M Reidenberg, Oliver Willis
The state medical board's review of appropriateness of prescribing opioids when a doctor–patient relationship is presumed to exist could decrease inappropriate criminal indictments and reduce this component of fear of prescribing adequate opioid therapy for patients in pain.
JAMAEfforts Aim to Curb Opioid Deaths, Injuries
36 Citations2009Bridget M. Kuehn
A multidisciplinary panel of experts on pain management from the American Pain Society and the American Academy of Pain Medicine published a clinical practice guideline on the use of opioid medications to treat chronic noncancer pain, aimed at reducing the risk of drug misuse while ensuring good pain management.
Journal of Substance Abuse TreatmentTrends in opioid-related fatal overdoses in Massachusetts, 1990–2003
31 Citations2006William G. Fernandez, Holly Hackman +3 more
To guide future public health interventions, further investigation is necessary to better delineate the specific opioids involved, the circumstances surrounding these deaths, and the medical and behavioral health care options available.