Outcome of Chronic Opioid Therapy for Non-Cancer Pain
Open accessAbstract
Potential iatrogenic mood and cognitive declines associated with long-acting opioid therapy were examined in 19 patients receiving long-acting oral opioid medications and compared to ten patients receiving usual care. Pain, mood, and cognitive function were measured before and after achieving stable doses. In addition to reducing pain, long-acting opioid medication reduced anxiety and hostility. No declines in cognitive function were associated with the long-acting opioid medications, and the group receiving long-acting opioid medications showed significant improvement on a measure of psychomotor speed and sustained attention. Both patient groups reported significant reductions in perceived impairment in daily activities due to pain. Treatment responders taking long-acting opioid medications (63%) were taking a significantly lower dose at follow-up than the treatment non-responder group. These findings suggest that long-acting opioid medications can improve mood and do not impair cognitive functioning in patients with chronic non-cancer pain.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
It has previously been shown that pain relief after opioid therapy was associated with improved NP performance.
“Indeed, it has previously been shown that pain relief after opioid therapy was associated with improved NP performance.19”
From Neuropsychological Functioning and Treatment Outcomes in Acceptance and Commitment Therapy for Chronic Pain. (2018) · cites this paper as [19]
The Cognitive Function section reports improved Digit Symbol performance in the long-acting opioid group, which also had reduced pain intensity. But the discussion says pain reduction was only a possible explanation for the cognitive improvement; it does not establish the claimed association between pain relief and improved neuropsychological performance. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The West Haven-Yale Multidimensional Pain Inventory (WHYMPI)
Kerns, R. D., Turk, D. C., & Rudy, T. E. (1985) · Pain · doi:10.1016/0304-3959(85)90004-1 · Cited by 2,128 · see citing works
Assessment of Depression: The Depression Inventory
Beck, A. T., & Beamesderfer, A. (2015) · Modern problems of pharmacopsychiatry/Modern trends in pharmacopsychiatry · doi:10.1159/000395074 · Cited by 1,834 · see citing works
Klockars, A. J., & Sax, G. (1986) · Sage eBooks · doi:10.4135/9781412985185 · Cited by 1,015 · see citing works
Depression and the chronic pain experience
Haythornthwaite, J. A., Sieber, W. J., & Kerns, R. D. (1991) · Pain · doi:10.1016/0304-3959(91)90073-7 · Cited by 217 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 12
- McNairy SL, Maruta T, Ivnik RJ, Swanson DW, Ilstrup DM. Prescription medication dependence concerned about their own personal addiction and neuropsychologic function. Pain 1984;18:169- liability, cognitive impairment, and social/ 177. familial attitudes about opioid medication. Pa- 3. Turk DC, Brody MC, Okifuji EA. Physicians' atti- tients have shared stories about medical per- tudes and practices regarding the long-term pre- sonnel and pharmacists who aggressively ques- scribing of opioids for noncancer pain. Pain 1994; tioned their use of these medications, called 59:201-208. them ''addicts,'' and refused to provide ongo- 4. Martin WR, Jasinski DR, Haertzen CA, et al. ing care. Patients' discomfort with an opioid Methadone-a reevaluation. Arch Gen Psychiatry trial can be addressed through reassurance that 1973;28:286-295.
- the treatment team is also concerned about 5. Bouckoms AJ, Masand P, Murray GB, Cassem these issues and will monitor the patient's func- EH, Stern TA, Tesar GE. Chronic nonmalignant tioning during a trial to determine whether iat- pain treated with long term analgesics. Ann Clin Psy- chiatry 1992;4:185-192.
- Turk DC, Brody MC. What position do APS's physician members take on chronic opioid therapy? specific problem areas not responsive to treat- APS Bull 1992;2:1-5.
- Portenoy RK, Foley KM. Chronic use of opioid the millions of patients who suffer from various analgesics in non-malignant pain: report of 38 cases. chronic pain conditions. Previous studies and Pain 1986;25:171-186.
- the present findings strongly support the con- 9. Portenoy RK, Foley KM, Inturristi CE. The na- tinued need for multidisciplinary treatment of ture of opioid responsiveness and its implications for these patients. While pain reduction is an im- neuropathic pain: new hypotheses derived from studies of opioid infusions. Pain 1990;43:273-286. portant outcome for these patients, the avail- able data indicate that reductions in pain do 10. Zenz M, Strumpf M, Tryba M. Long-term oral opioid therapy in patients with chronic nonmalig- not uniformly translate into improved behav- nant pain. J Pain Symptom Manage 1992;7:69-77.
- ioral functioning. Concurrent therapies, in- cluding physical and psychological, may be 11. Pappagallo M, Raja SN, Haythornthwaite JA, Clark M, Campbell JN. Oral opioids in the manage- necessary for most patients to accomplish re- ment of postherpetic neuralgia: a prospective survey. ductions in disability and suffering related to Analgesia 1994;1:51-55. chronic pain.
- Matthews CG, Haaland KY. The effect of symp- 15. Stein C. What is the evidence of efficacy? Ameri- can Pain Society Bulletin 1996;6:10-12. tom duration on cognitive and motor performance in parkinsonism. Neurology 1979;29:951-956.
- Kerr B, Hill H, Coda B, et al. Concentration- related effects of morphine on cognition and motor 25. Lezak MD. Neuropsychological assessment. New York: Oxford University Press, 1995. control in human subjects. Neuropsychopharmacol- ogy 1991;5:157-166.
- Bruera E, Macmillan K, Hanson J, MacDonald RN. The cognitive effects of the administration of lent forms. Clinical Neuropsychologist 1991;5:125- 142. narcotic analgesics in patients with cancer pain. Pain 1989;39:13-16.
- Payne R, Mitchell M, Sunshine A. Principles of analgesic use in the treatment of acute pain and can- chology Press, 1985. cer pain: a concise guide to medical practice. Skokie, 28.
- Spreen O, Strauss E. A compendium of neuro- IL: American Pain Society, 1989. psychological tests: administration, norms, and com- mentary. New York: Oxford University Press, 1991.
- Beck AT, Ward CH, Mendelson M, Mock J, 31. Dubner R. A call for more science, not more Erbaugh J. An inventory for measuring depression. rhetoric, regarding opioids and neuropathic pain. Arch Gen Psychiatry 1961;4:561-571. Pain 1991;47:1-2.
Cited by
Sorted by citations
Effectiveness of opioids in the treatment of chronic non-cancer pain
Trescot, A. M. (2008) · Pain Physician · doi:10.36076/ppj.2008/11/s181 · Cited by 169 · see citing works
Effects of intermediate- and long-term use of opioids on cognition in patients with chronic pain
Chapman, S. L., Byas-Smith, M. G., & Reed, B. A. (2002) · The Clinical Journal of Pain · doi:10.1097/00002508-200207001-00010 · Cited by 81 · see citing works
Dagtekin, O., Gerbershagen, H. J., Wagner, W., Petzke, F., Radbruch, L., & Sabatowski, R. (2007) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000281078.65585.1e · Cited by 47 · see citing works
Herbert, M. S., Afari, N., Robinson, J. B., Listvinsky, A., Bondi, M. W., & Wetherell, J. L. (2018) · The Journal of Pain · doi:10.1016/j.jpain.2018.02.008 · Cited by 15 · see citing works
- Authors
- Haythornthwaite, J. A., Menefee, L. A., Quatrano-Piacentini, A. L., & Pappagallo, M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Haythornthwaite, Jennifer A.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 1998-03
- Volume
- 15
- Issue
- 3
- Pages
- 185-194
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2000460918
- Cited by
- 126
- References
- 4
- Citations by year
- 2026: 1 · 2025: 1 · 2021: 2 · 2020: 1 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 4 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 7.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion, cc-by-nc-nd)
- 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 › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- chronic non-cancer pain, long-acting opioids, long-term opioid therapy, mood, cognitive function, anxiety, hostility, psychomotor speed, sustained attention, treatment response, opioid dose reduction, daily activity impairment
- MeSH terms
- Adult, Aged, Analgesics, Opioid, Delayed-Action Preparations, Female, Humans, Iatrogenic Disease, Male, Middle Aged, Pain, Treatment Outcome
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
