Neobook — clinical reference

Conclusion

A carefully considered comprehensive pain management strategy that includes chronic opioid therapy (COT) in carefully selected patients with no history of addiction or drug abuse may achieve long-term pain control with a manageable side-effect profile and a low risk of addiction or serious adverse effects.^[12] However, there is limited published evidence of long-term efficacy on which to base evidence-based guidelines and much of this guideline is based on evidence consensus and practice patterns rather than on high-quality studies alone. Therefore, appropriate evaluation, including biopsychosocial screening and risk screening, is essential before initiating COT and during continued therapy. It is hoped that this guideline will assist clinicians in selectively using COT for patients who will benefit and simultaneously attempt to avoid the inappropriate and abusive use of opioid analgesics.

References

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British Pain Society. Opioids for persistent pain: Good Practice. A consensus statement prepared on behalf of the British Pain Society, the Faculty of Pain Medicine of the Royal College of Anaesthetists, the Royal College of General Practitioners and the Faculty of Addictions of the Royal College of Psychiatrists. London, UK: British Pain Society; 2010.
Chou R, Fanciullo GJ, Fine PG, et al; American Pain Society – American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of opioid therapy in chronic noncancer pain. J Pain 2009;10(2):113-130. [http://dx.doi.org/10.1016/j.jpain.2008.10.008]
Canadian National Opioid Use Guideline Group. Canadian Guideline for safe and effective use of opioids for chronic non-cancer pain. San Francisco: National Opioid Use Guideline Group, 2010. http://nationalpaincentre.mcmaster.ca/documents/opioid_guideline_part_b_v5_6.pdf (accessed 20 November 2013).
Manchikanti L, Abdi S, Atluri S, et al. American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: Part 2 – Guidance. Pain Physician 2012;15(3 Suppl):S67-S116.
Eastern Metropolitan Region Palliative Care Consortium. Opioid conversion ratios – Guide to practice 2010. http://www.emrpcc.org.au/wp-content/uploads/2013/03/EMRPCC-Opioid-Conversion2010-Final2.pdf (accessed 20 November 2013).
Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip and knee. Arthritis Care Res 2012;64(4):465-474. [https://doi.org/10.1002/acr.21596]
Braun J, van den Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011;70:896-904. 2011;70:896-904. [http://dx.doi.
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Whittle SL, Richards BL, Buchbinder R. Opioid analgesics for rheumatoid arthritis pain. JAMA 2013;309(5):485-486. [http://dx.doi.org/10.1001/jama.2012.193412]
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Further reading

Chronic non-cancer pain (CNCP) and COT

Cohen MI, Wodak AD. Opioid prescribing in general practice: A trial run approach. Modern Medicine of South Africa 2013;38(1):37-43.
de Leon-Casasola OA. Opioids for chronic pain: New evidence, new strategies, safe prescribing. Am J Med 2013;126(3):S3-S11. [http://dx.doi.org/10.1016/j.amjmed.2012.11.011]
Gronow DW. The place of pharmacological treatment of chronic pain. Anesth Int Care Med 2011;12(2):39-41. [http://dx.doi.org/10.1016/j.mpaic.2010.10.015]
Minozzi S, Amato L, Davoli M. Development of dependence following treatment with opioid analgesics for pain relief: A systematic review. Addiction 2013;108(4):688-698. [http://dx.doi.org/10.1111/j.1360-0443.2012.04005.x]
Trescot AM, Boswell MV, Atluri SL, et al. Opioid guidelines in the management of chronic non-cancer pain. Pain Physician 2006;9(1):1-39.

Arthritis

American Academy of Orthopedic Surgeons (AAOS). Treatment of Osteoarthritis of the Knee: Evidence-based Guideline. 2nd ed. Rosemont, Illinois: AAOS, 2013. http://www.aaos.org/research/guidelines/TreatmentofOsteoarthritisoftheKneeGuideline.pdf (accessed 20 November 2013).
Whittle SL, Richards BL, van der Heijde DM, Buchbinder R. The efficacy and safety of opioids in inflammatory arthritis: A Cochrane systematic review. J Rheumatol Suppl 2012;90:40-46. [http://dx.doi.org/10.3899/jrheum.120341]

Fibromyalgia

Fitzcharles M-A, Ste-Marie PA, Goldberg DL, et al. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: Executive summary. Pain Res Manag 2013;18(3):119-126.

Chronic pelvic pain

Fall M, Baranowski AP, Elneil S, et al; European Association of Urology. EAU guidelines on chronic pelvic pain. Eur Urol 2010;57(1):35-48. [http://dx.doi.org/10.1016/j.eururo.2009.08.020]
Nickel JC. Opioids for chronic prostatitis and interstitial cystitis: Lessons learned from the 11th World Congress on Pain. Urology 2006;68(4):697-701.