Authors' results and conclusions: There is uncertainty related to the prescribing of opioid analgesics to treat chronic pain in adult patients with opioid use disorder (OUD) or a history of OUD. Guidance is required on the optimal prescribing of opioid analgesics to ensure that patients are benefiting from treatment with minimal harm. This systematic review examined 5 observational studies on the safety of opioid analgesics alone or with opioid agonist therapy for chronic pain in patients with OUD or a history of OUD. No evidence was found regarding the efficacy of opioid analgesics for managing chronic pain in these patients. Low certainty evidence suggests a reduced risk of fatal opioid-related toxicity for those receiving both treatments compared to opioid analgesics alone. Uncertainty remains about the impact on toxicity risks, prolonged opioid use, and opioid analgesic dosage or frequency. Further research is needed, especially for Indigenous and equity-deserving populations.

Project Status: Completed

URL for project: https://www.cda-amc.ca/opioid-analgesics-treat-chronic-noncancer-pain-among-patients-prescribed-opioid-agonist-therapy-or

Year Published: 2024

URL for published report: https://www.cda-amc.ca/sites/default/files/pdf/htis/2024/RE0045_Opioid_Analgesics_Report.pdf

URL for additional information: https://www.cda-amc.ca/opioid-analgesics-treat-chronic-noncancer-pain-among-patients-prescribed-opioid-agonist-therapy-or

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: Canada’s Drug Agency (CDA-AMC)

Contact Address: 865 Carling Ave., Suite 600 Ottawa, ON Canada K1S 5S8

Contact Name: Shannon Nordstrom

Contact Email: shannon.nordstrom@cda-amc.ca

Copyright: 2025 Canadian Agency for Drugs and Technologies in Health