Despite low-quality evidence supporting practice change, use of opioids for chronic pain increased dramatically over the past two decades. Concurrently, there has been a sharp increase in opioid analgesic overdose deaths, addiction, misuse and diversion.
Opioids may provide modest, variable short-term pain relief for some patients with chronic pain.
Long-term benefits for chronic pain have not been established. Potential medical and behavioral harms of opioids are an important concern, particularly at higher dosage levels and in higher risk or medically complex patients.
While opioid therapy at lower doses may be a useful treatment for some patients, it should only be considered for carefully evaluated, closely monitored patients when a cautious, structured and selective approach is employed, and clear benefits for pain and function are documented.
Opioid treatment always entails risks for patients, their families and the community, so vigilance and caution are essential.
