The DOI matches its Crossref record; 64 of the 64 references it cites were found in a registry or an index.
Long-term opioid therapy: Assessment of consequences and risks
Open accessAbstract
Medical practice with respect to the use of opioids for the treatment of pain has been heavily influenced by societal perceptions of problems of addiction and by laws governing the use of opioids. To effectively use opioids for the treatment of chronic pain, physicians must recognize pervasive, but clinically often irrelevant societal and legal influences on prescribing, while at the same time respecting opioid properties which may lead to unwanted consequences in the course of opioid therapy. This paper reviews history and legislation that has shaped medical prescribing of opioids, examines the potential risks and consequences of long-term opioid therapy and assesses three models of long-term opioid therapy.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Thus, the ACT group was at higher risk of persistent pain, pain-related disability, depression, and long-term, high-dose opioid use.6,13,41”
Citations
Cites
Cellular and molecular mechanisms of drug dependence
Koob, G. F., & Bloom, F. E. (1988) · Science · doi:10.1126/science.2903550 · Cited by 2,070
[Drug addiction and drug abuse].
Feuerlein, W. (1969) · PubMed · Cited by 1,415
The NIMH Epidemiologic Catchment Area Program
Regier, D. A. (1984) · Archives of General Psychiatry · doi:10.1001/archpsyc.1984.01790210016003 · Cited by 1,257
Opioid analgesics and antagonists
Reisine, T. (1996) · Medical Entomology and Zoology · Cited by 1,205
Addiction Rare in Patients Treated with Narcotics
(1980) · New England Journal of Medicine · doi:10.1056/nejm198001103020221 · Cited by 1,106
Undertreatment of Medical Inpatients with Narcotic Analgesics
MARKS, R. M., & SACHAR, E. J. (1973) · Annals of Internal Medicine · doi:10.7326/0003-4819-78-2-173 · Cited by 1,103
The Effectiveness of Methadone Maintenance Treatment
Ball, J. C., & Ross, A. (1991) · Springer eBooks · doi:10.1007/978-1-4613-9089-3 · Cited by 1,088
Pain and Behavioral Medicine: A Cognitive-Behavioral Perspective
Turk, D., Meichenbaum, D. H., Genest, M., & Berntzen, D. (1984) · Scandinavian Journal of Behaviour Therapy · doi:10.1080/16506078409455719 · Cited by 977
Santé et Médecine en Afrique Tropicale
MuiQuy, B. (1981) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.1981.30.5.tm0300051146a · Cited by 969
Substance Abuse: A Comprehensive Textbook
Lowinson, J. H. (1992) · Cited by 909
The Effectiveness of Methadone Maintenance Treatment: Patients, Programs, Services, and Outcome
Ball, J. C., & Ross, A. O. (1991) · Cited by 903
Substance Abuse: A Comprehensive Textbook
Krueger, A. L. (1993) · JAMA · doi:10.1001/jama.1993.03500040103051 · Cited by 868
Duffy, J. C., & Musto, D. F. (1973) · The American Historical Review · doi:10.2307/1854220 · Cited by 743
The American Disease, Origins Of Narcotic Control
Musto, D. F. (1999) · doi:10.1093/oso/9780195125092.001.0001 · Cited by 678
Opioid pseudoaddiction — an iatrogenic syndrome
Weissman, D. E., & Haddox, J. D. (1989) · Pain · doi:10.1016/0304-3959(89)90097-3 · Cited by 644
The Natural History of Alcoholism
Taylor, J. R., & Helzer, J. E. (1983) · Springer eBooks · doi:10.1007/978-1-4684-4274-8_2 · Cited by 623
Brecher, E. M. (1972) · Cited by 526
Acute Pain Management: Operative or Medical Procedures and Trauma
Follin, S. L., & Charland, S. L. (1997) · Annals of Pharmacotherapy · doi:10.1177/106002809703100917 · Cited by 491
Sternbach, R. A. (1986) · Raven Press eBooks · Cited by 415
Long-term oral opioid therapy in patients with chronic nonmalignant pain
Zenz, M. W., Strumpf, M., & Tryba, M. (1992) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(92)90116-y · Cited by 356
Management of pain during debridement: a survey of U.S. burn units
Perry, S. W., & Heidrich, G. (1982) · Pain · doi:10.1016/0304-3959(82)90016-1 · Cited by 329
Acute pain management: operative or medical procedures and trauma.
Ka, P. (1993) · PubMed · Cited by 326
The multidimensional nature of cancer-related pain
Ahles, T. A., Blanchard, E. B., & Ruckdeschel, J. C. (1983) · Pain · doi:10.1016/0304-3959(83)90100-8 · Cited by 309
DOLE, V. P. (1966) · Archives of Internal Medicine · doi:10.1001/archinte.1966.00290160004002 · Cited by 290
Patterns of illness behaviour in patients with intractable pain
Pilowsky, I., & Spence, N. D. (1975) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(75)90026-4 · Cited by 283
Controversies in the long-term management of analgesic therapy in patients with advanced cancer
Portenoy, R. K., & Coyle, N. (1990) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(90)90047-n · Cited by 269
Medical safety and side effects of methadone in tolerant individuals
Kreek, M. J. (1973) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1973.03220060039009 · Cited by 247
The role of psychological factors in chronic pain. I. A half century of study
Gamsa, A. (1994) · Pain · doi:10.1016/0304-3959(94)90103-1 · Cited by 241
Morgan, J. P. (1985) · Advances in Alcohol & Substance Abuse · doi:10.1300/j251v05n01_11 · Cited by 174
Cold-pressor pain tolerance in opiate and cocaine abusers: Correlates of drug type and use status
Compton, M. A. (1994) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(94)90203-8 · Cited by 164
Alcoholism : origins and outcome
Rose, R. M., & Barrett, J. E. (1988) · Raven Press eBooks · Cited by 161
Morse, R. M. (1992) · JAMA · doi:10.1001/jama.1992.03490080086030 · Cited by 158
LONG‐TERM OUTCOME OF PATIENTS TREATED WITH METHADONE MAINTENANCE*
Dole, V. P., & Joseph, H. (1978) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1978.tb16775.x · Cited by 158
Donovan, D. M. (1993) · JAMA · doi:10.1001/jama.1993.03500050064013 · Cited by 155
Opioid use in the treatment of chronic pain: Assessment of addiction
Sees, K. L., & Clark, H. W. (1993) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(93)90154-n · Cited by 140
Long-term use of opioid analgesics for the treatment of chronic pain of nonmalignant origin
Schofferman, J. A. (1993) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(93)90156-p · Cited by 138
Rapoport, A. M. (1988) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.1988.hed2810662.x · Cited by 122
Clinical experience with diamorphine in advanced malignant disease.
Rg, T. (1974) · PubMed · Cited by 120
The role of psychological factors in chronic pain. II. A critical appraisal
Gamsa, A. (1994) · Pain · doi:10.1016/0304-3959(94)90104-x · Cited by 118
Treatment Principles for the Use of Opioids in Pain of Nonmalignant Origin
Schug, S. A., Merry, A., & Acland, R. H. (1991) · Drugs · doi:10.2165/00003495-199142020-00005 · Cited by 112
Addiction in the treatment of pain: Significance, recognition, and management
Savage, S. R. (1993) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(93)90155-o · Cited by 98
Self-citationChin, M. L. (1993) · Anesthesia & Analgesia · doi:10.1213/00000539-199303000-00083 · Cited by 90
Self-administration of morphine in bone marrow transplant patients reduces drug requirement
Hill, H. F., Chapman, R. C., Kornell, J. A., Sullivan, K. M., Saeger, L. C., & Benedetti, C. (1990) · Pain · doi:10.1016/0304-3959(90)90062-i · Cited by 85
Neurobiological Mechanisms of Opioid Tolerance and Dependence
Collin, E., & Cesselin, F. (1991) · Clinical Neuropharmacology · doi:10.1097/00002826-199112000-00001 · Cited by 81
The effects of detoxification, relaxation, and brief supportive therapy on chronic pain
Taylor, C. B., Zlutnick, S. I., Corley, M. J., & Flora, J. A. (1980) · Pain · doi:10.1016/0304-3959(80)90077-9 · Cited by 79
EXPERIENCE IN THE MANAGEMENT OF PATIENTS MEDICALLY ADDICTED TO NARCOTICS
Rayport, M. (1954) · JAMA · doi:10.1001/jama.1954.02950070012004 · Cited by 67
Magnitude of Acute Tolerance to Opioids Is Not Related to Their Potency
Kissin, I., Brown, P. T., & Bradley, E. L. (1991) · Anesthesiology · doi:10.1097/00000542-199111000-00013 · Cited by 65
Finlayson, R. E., Maruta, T., Morse, R. M., Swenson, W. M., & Martin, M. A. (1986) · Pain · doi:10.1016/0304-3959(86)90072-2 · Cited by 63
Ra, B., & Taub, A. (1978) · PubMed · Cited by 59
Animal models of drug self-administration
(1992) · Pharmacology Biochemistry and Behavior · doi:10.1016/0091-3057(92)90553-r · Cited by 55
Substance dependence and chronic pain: Experience with treatment and follow-up results
Finlayson, R. E., Maruta, T., Morse, R. M., & Martin, M. A. (1986) · Pain · doi:10.1016/0304-3959(86)90073-4 · Cited by 53
The refractory headache patient—II. High medication consumption (analgesic rebound) headache
Michultka, D. M., Blanchard, E. B., Appelbaum, K. A., Jaccard, J. J., & Dentinger, M. P. (1989) · Behaviour Research and Therapy · doi:10.1016/0005-7967(89)90012-0 · Cited by 45
Prescription of opioids for treatment of pain in patients with addictive disease
Wesson, D. R., Ling, W. W., & Smith, D. E. (1993) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(93)90157-q · Cited by 44
Patient-controlled analgesic infusions: alfentanil versus morphine
Hill, H. F., Coda, B. A., Mackie, A. M., & Iverson, K. (1992) · Pain · doi:10.1016/0304-3959(92)90235-4 · Cited by 40
Chronic pain and substance abuse: A pilot study of opioid maintenance
Kennedy, J. A. (1990) · Journal of Substance Abuse Treatment · doi:10.1016/0740-5472(90)90046-s · Cited by 39
Prescription drug abuse. Patient, physician, and cultural responsibilities.
Wesson, D. R., & Smith, D. E. (1990) · PubMed · Cited by 36
Opioids, chronic pain, and the law
Clark, H. W., & Sees, K. L. (1993) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(93)90158-r · Cited by 35
Alcohol use by heroin addicts 12 years after drug abuse treatment.
Lehman, W. E. K., Barrett, M. E., & Simpson, D. D. (1990) · Journal of Studies on Alcohol · doi:10.15288/jsa.1990.51.233 · Cited by 31
Assessment and Relief of Pain in Chemically Dependent Patients
McCaffery, M., & Vourakis, C. (1992) · Orthopaedic Nursing · doi:10.1097/00006416-199203000-00004 · Cited by 30
Glass, R. M. (1993) · JAMA · doi:10.1001/jama.1993.03500150107038 · Cited by 28
Alcoholism: Origins and Outcomes
Tarter, R. E. (1989) · Journal of Studies on Alcohol · doi:10.15288/jsa.1989.50.278 · Cited by 26
Knowledge of medical students, residents, and attending physicians about opiate abuse
Shine, D., & Demas, P. (1984) · Academic Medicine · doi:10.1097/00001888-198406000-00007 · Cited by 23
The spinal pharmacology of acutely and chronically administered opioids
Yaksh, T. L. (1992) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(92)90089-z · Cited by 12
Pharmacotherapy of Cancer Pain
Cherny, N. I., & Portenoy, R. K. (1993) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-1993-3205 · Cited by 6
Research works printed but not linked: 4
- Kolb, 1925, Types and characteristics of drug addicts, Mental Hygiene, 9, 300
- Portenoy, 1990, Chronic opioid therapy in nonmalignant pain, J Pain Symptom Manage, 5, S46
- Kudrow, 1982, Paradoxical effect of frequent analgesic use, Adv Neural, 33, 335
- Savage, 1994, Pain treatment in the addicted patient, Drug Ther Bull
Cited by
Sorted by citations
Opioid Therapy for Chronic Pain
Ballantyne, J. C., & Mao, J. (2003) · New England Journal of Medicine · doi:10.1056/nejmra025411 · Cited by 960
Opioids and the treatment of chronic pain: Controversies, current status, and future directions.
Rosenblum, A., Marsch, L. A., Joseph, H., & Portenoy, R. K. (2008) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0013628 · Cited by 648
Rosenblum, A. (2003) · JAMA · doi:10.1001/jama.289.18.2370 · Cited by 523
Universal Precautions in Pain Medicine: A Rational Approach to the Treatment of Chronic Pain
Gourlay, D. L., Heit, H. A., & Al-Mahrezi, A. M. (2005) · Pain Medicine · doi:10.1111/j.1526-4637.2005.05031.x · Cited by 524
Trends in long‐term opioid therapy for chronic non‐cancer pain
Boudreau, D. M., Korff, M. V., Rutter, C. M., Saunders, K. W., Ray, G. T., Sullivan, M. D., Campbell, C. I., Merrill, J. O., Silverberg, M. J., Banta‐Green, C. J., et al. (2009) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1833 · Cited by 522
Metadata
- Authors
- Savage, S. R.
- Affiliations
- Dartmouth–Hitchcock Medical Center (US)
- Corresponding author
- Savage, Seddon R.
- ORCID
- Savage, Seddon R.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 1996-05
- Volume
- 11
- Issue
- 5
- Pages
- 274-286
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2059291642
- Cited by
- 176
- References
- 64
- Citations by year
- 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 7 · 2016: 1 · 2015: 5 · 2014: 1 · 2013: 4 · 2012: 7
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Keywords
- long-term opioid therapy, chronic pain, opioid prescribing, opioid use disorder, opioid risks
- MeSH terms
- Analgesics, Opioid, Drug Administration Schedule, Drug Tolerance, Humans, Opioid-Related Disorders, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
