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Pain Management

Opioid guidelines: helpful for the rheumatologist?

Opioids are increasingly used for the treatment of chronic noncancer pain, but this practice remains controversial. A new set of clinical recommendations attempts to guide clinicians through the issues.

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References

  1. Caudill-Slosberg, M. A., Schwartz, L. M. & Woloshin, S. Office visits and analgesic prescriptions for musculoskeletal pain in the US: 1980 vs 2000. Pain 109, 514–519 (2004).

    Article  Google Scholar 

  2. Chou, R. et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J. Pain 10, 113–130 (2009).

    Article  CAS  Google Scholar 

  3. Fishman, S. M. & Kreis, P. G. The opioid contract. Clin. J. Pain 18 (Suppl.), S70–S75 (2002).

    Article  Google Scholar 

  4. Furlan, A. D., Sandoval, J. A., Mailis-Gagnon, A. & Tunks, E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ 174, 1589–1594 (2006).

    Article  Google Scholar 

  5. Katz, W. A. Opioids for nonmalignant pain. Rheum. Dis. Clin. North Am. 34, 387–413 (2008).

    Article  Google Scholar 

  6. Passik, S. D. et al. Monitoring outcomes during long-term opioid therapy for noncancer pain: results with the Pain Assessment and Documentation Tool. J. Opioid Manag. 1, 257–266 (2005).

    Article  Google Scholar 

  7. Fitzcharles, M. A., Almahrezi, A. & Shir, Y. Pain: understanding and challenges for the rheumatologist. Arthritis Rheum. 52, 3685–3692 (2005).

    Article  Google Scholar 

  8. Lamb, L., Pereira, J. X. & Shir, Y. Nurse case management program of chronic pain patients treated with methadone. Pain Manag. Nurs. 8, 130–138 (2007).

    Article  Google Scholar 

  9. Fishbain, D. A., Cutler, R. B., Rosomoff, H. L. & Rosomoff, R. S. Can patients taking opioids drive safely? A structured evidence-based review. J. Pain Palliat. Care Pharmacother. 16, 9–28 (2002).

    Article  Google Scholar 

  10. Fitzcharles, M. A., DaCosta, D., Ware, M. A. & Shir, Y. Patient barriers to pain management may contribute to poor pain control in rheumatoid arthritis. J. Pain 3, 300–305 (2009).

    Article  Google Scholar 

Download references

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Correspondence to Mary-Ann Fitzcharles.

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Competing interests

M. -A. Fitzcharles has received speakers' honoraria from Biovale and Purdue Pharma.

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Fitzcharles, MA., Shir, Y. Opioid guidelines: helpful for the rheumatologist?. Nat Rev Rheumatol 5, 242–244 (2009). https://doi.org/10.1038/nrrheum.2009.63

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