Special report: chronic noncancer pain—long-term opioid benefits and harms
BlueCross BlueShield Association
Record ID 32013000447
English
Authors' recommendations:
Chronic pain is often unrelieved and undertreated and a significant patient and public health concern
with substantial costs. Many interventions hold potential benefit for CNCP including pharmacologic,
and nonpharmacologic (interventional and multidisciplinary/interdisciplinary rehabilitative). Opioids
have been shown to be effective for short-term pain relief. However, when used long-term for CNCP
and compared to other interventions, evidence to clearly define the net clinical benefit (balance of
benefits and harms) and functional outcomes is lacking.
The burden of opioid-related harms has increased substantially in recent decades. Harms affect both
treated patients and spread or spillover to individuals of all ages—from nonmedical use in adults and
adolescents to neonates experiencing abstinence syndrome or suffering from birth defects. In 2009,
there were 14,800 deaths attributed to prescription opioids—representing a 3.7-fold increase over a
decade. Existing guidelines recommend using opioids for CNCP in patients with inadequate response
to non-opioid alternatives. However, achieving a favorable balance of benefits and harms in the
setting of CNCP requires prescribing informed by the best available evidence.
Providing patients suffering from chronic pain with effective treatment is an important goal, and
many interventions are available. Opioids are but one alternative and one accompanied by potential
harms to patients and others. Given the experience with opioids, effectively relieving pain, improving
function, and minimizing harms in patients with CNCP will require concerted and coordinated efforts
of health care providers, regulatory authorities, the public and payers, together with patients.
Details
Project Status:
Completed
Year Published:
2012
URL for published report:
http://www.bcbs.com/blueresources/tec/vols/27/27_01.pdf
URL for additional information:
http://www.bcbs.com/blueresources/tec/vols/27/special-report-chronic.html
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Anti-Inflammatory Agents, Non-Steroidal
- Blue Cross Blue Shield Insurance Plans
- Disease Management
- Technology Assessment, Biomedical
- United States
- Analgesics, Opioid
- Anticonvulsants
- Antidepressive Agents
- Chronic Disease
- Pain
Contact
Organisation Name:
BlueCross BlueShield Association
Contact Address:
BlueCross BlueShield Association, Technology Evaluation Center, 225 North Michigan Ave, Chicago, Illinois, USA. Tel: 888 832 4321
Contact Name:
tec@bcbsa.com
Contact Email:
tec@bcbsa.com
Copyright:
BlueCross BlueShield Association (BCBS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.