Investigators Conclude Long-term Opioid Use Increases Dependency and Overdose Risks
The opioid epidemic has raised questions regarding the long-term use of opioids for chronic pain conditions. The authors of a new study looked at the utility of long-term opioids in patients with polyneuropathy, one of the most common painful conditions managed in general practice.
Nearly 2,900 patients with polyneuropathy were assessed in a retrospective, population-based, cohort study to assess opioid prevalence as well as functional status and adverse outcomes. Patients with polyneuropathy who were receiving long-term opioids exhibited multiple functional status markers that were modestly poorer even after adjusting for medical comorbidity, including increased reliance on gait aids (odds ratio, 1.9; 95% confidence interval, 1.4-2.6). No functional status markers were improved by long-term use of opioids, while adverse outcomes were more common, including depression (adjusted hazard ratio [HR], 1.53), opioid dependence (HR, 2.85), and opioid overdose (HR, 5.12). The authors concluded that “long-term opioid therapy did not improve functional status but rather was associated with a higher risk of subsequent opioid dependency and overdose” (JAMA Neurol. Published online May 22, 2017. doi:10.1001/jamaneurol.2017.0486).
An accompanying editorial noted that lack of evidence for benefit from long-term opioid use and accumulating evidence of harm has prompted the CDC to publish new guidelines recommending that opioids not be used as first-line treatment agents for the management of chronic pain, and if used, opioids only should be used as an adjunct to a comprehensive pain management program (JAMA Neurol. Published online May 22, 2017. doi:10.1001/jamaneurol.2017.0466).
Nationwide epidemic has raised questions regarding the long-term use of such medication for chronic pain conditions.
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