The opioid epidemic and national guidelines for opioid therapy for chronic noncancer pain: a perspective from different continents
Open accessAbstract
Introduction: A marked rise in opioid prescriptions for patients with chronic noncancer pain (CNCP) with a parallel increase in opioid abuse/misuse, and resulting deaths was noted in the Unites states in the past decade (opioid epidemic). In response, the US Center of Diseases Control (CDC) developed a guideline for prescribing of opioids for patients with CNCP. Objectives: To assess (1) if there is an opioid epidemic in Australia, Canada, and Germany (2) to compare Australian, Canadian, German, and Center of Diseases Control guidelines recommendations for long-term opioid therapy for CNCP. Methods: National evidence-based guidelines and PubMed were searched for recommendations for opioid prescriptions for CNCP. Results: There are signs of an opioid epidemic in Australia and Canada, but not in Germany. Guidelines in all 4 countries provide similar recommendations: opioids are not the first-line therapy for patients with CNCP; regular clinical assessments of benefits and harms are necessary; excessive doses should be avoided (recommended morphine equivalent daily doses range from 50 to 200 mg/d); stopping rules should be followed. All guidelines do not recommend the use of opioids in chronic pain conditions without an established nociceptive or neuropathic cause such as fibromyalgia and primary headache. Conclusion: Implementation of opioid prescribing guidelines should ensure that physicians prescribe opioids only for appropriate indications in limited doses for selected patients and advice patients on their safe use. These measures could contribute to reduce prescription opioid misuse/abuse and deaths.
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- Authors
- Häuser, W., Schug, S., & Furlan, A. D.
- Affiliations
- Klinikum Saarbrücken (DE)
- The University of Western Australia (AU)
- University of Toronto (CA)
- Corresponding author
- Häuser, Winfried
- Venue
- PAIN Reports
- Published
- 2017-05
- Volume
- 2
- Issue
- 3
- Pages
- e599
- ISSN
- 2471-2531 (ISSN-L)
- PMC
- PMC5741305
- OpenAlex
- W2613863269
- Cited by
- 154
- References
- 54
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 4 · 2022: 19 · 2021: 22 · 2020: 26 · 2019: 26 · 2018: 30 · 2017: 4
- FWCI
- 22.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PAIN Reports (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Pfizer
- Seqirus
- Pfizer Pharmaceuticals
- Canadian Institutes of Health Research
- 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 › Surgery › Anesthesia and Pain Management
- Keywords
- opioid epidemic, chronic non-cancer pain, opioid prescribing guidelines, opioid misuse, opioid abuse, opioid-related deaths, CDC opioid prescribing guidelines, morphine equivalent daily dose, fibromyalgia, primary headache, Australia, Canada, Germany
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