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Healthcare 2016, 4(2), 29; doi:10.3390/healthcare4020029

Who Benefits from Chronic Opioid Therapy? Rethinking the Question of Opioid Misuse Risk

The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390, USA
These authors contributed equally to this work.
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Author to whom correspondence should be addressed.
Academic Editors: Robert J. Gatchel and Sampath Parthasarathy
Received: 24 February 2016 / Revised: 17 May 2016 / Accepted: 17 May 2016 / Published: 25 May 2016
(This article belongs to the Special Issue Low Back Pain: Recent Advances And Perspectives)
View Full-Text   |   Download PDF [209 KB, uploaded 27 May 2016]

Abstract

Beginning in the late 1990s, a movement began within the pain management field focused upon the underutilization of opioids, thought to be a potentially safe and effective class of pain medication. Concern for addiction and misuse were present at the start of this shift within pain medicine, and an emphasis was placed on developing reliable and valid methods and measures of identifying those at risk for opioid misuse. Since that time, the evidence for the safety and effectiveness of chronic opioid therapy (COT) has not been established. Rather, the harmful, dose-dependent deleterious effects have become clearer, including addiction, increased risk of injuries, respiratory depression, opioid induced hyperalgesia, and death. Still, many individuals on low doses of opioids for long periods of time appear to have good pain control and retain social and occupational functioning. Therefore, we propose that the question, “Who is at risk of opioid misuse?” should evolve to, “Who may benefit from COT?” in light of the current evidence. View Full-Text
Keywords: chronic pain; chronic low back pain; opioids; chronic opioid therapy; biopsychosocial approach chronic pain; chronic low back pain; opioids; chronic opioid therapy; biopsychosocial approach
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Huber, E.; Robinson, R.C.; Noe, C.E.; Van Ness, O. Who Benefits from Chronic Opioid Therapy? Rethinking the Question of Opioid Misuse Risk. Healthcare 2016, 4, 29.

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