The DOI matches its Crossref record; 141 of the 141 references it cites were found in a registry or an index.
Opioids for low back pain
Open accessAbstract
Back pain affects most adults, causes disability for some, and is a common reason for seeking healthcare. In the United States, opioid prescription for low back pain has increased, and opioids are now the most commonly prescribed drug class. More than half of regular opioid users report back pain. Rates of opioid prescribing in the US and Canada are two to three times higher than in most European countries. The analgesic efficacy of opioids for acute back pain is inferred from evidence in other acute pain conditions. Opioids do not seem to expedite return to work in injured workers or improve functional outcomes of acute back pain in primary care. For chronic back pain, systematic reviews find scant evidence of efficacy. Randomized controlled trials have high dropout rates, brief duration (four months or less), and highly selected patients. Opioids seem to have short term analgesic efficacy for chronic back pain, but benefits for function are less clear. The magnitude of pain relief across chronic non-cancer pain conditions is about 30%. Given the brevity of randomized controlled trials, the long term effectiveness and safety of opioids are unknown. Loss of long term efficacy could result from drug tolerance and emergence of hyperalgesia. Complications of opioid use include addiction and overdose related mortality, which have risen in parallel with prescription rates. Common short term side effects are constipation, nausea, sedation, and increased risk of falls and fractures. Longer term side effects may include depression and sexual dysfunction. Screening for high risk patients, treatment agreements, and urine testing have not reduced overall rates of opioid prescribing, misuse, or overdose. Newer strategies for reducing risks include more selective prescription of opioids and lower doses; use of prescription monitoring programs; avoidance of co-prescription with sedative hypnotics; and reformulations that make drugs more difficult to snort, smoke, or inject.
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1 retracted
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Cited by
Maher, C., Underwood, M., & Buchbinder, R. (2017) · The Lancet · doi:10.1016/s0140-6736(16)30970-9 · Cited by 2,535
Prevention and treatment of low back pain: evidence, challenges, and promising directions
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New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults
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Primary care management of non-specific low back pain: key messages from recent clinical guidelines
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Metadata
- Authors
- Deyo, R. A., Von Korff, M., & Duhrkoop, D.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2015-01-05
- Volume
- 350
- Issue
- jan05 10
- Pages
- g6380-g6380
- ISSN
- 1756-1833 (ISSN-L)
- OpenAlex
- W2060302340
- Cited by
- 507
- References
- 141
- FWCI
- 45.29
- Type
- journal article
- Language
- en
- Open access
- green
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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