Guideline for opioid therapy and chronic noncancer pain
Open accessAbstract
Chronic noncancer pain includes any painful condition that persists for at least three months and is not associated with malignant disease.[1][1] According to seven national surveys conducted between 1994 and 2008, 15%–19% of Canadian adults live with chronic noncancer pain.[2][2] Chronic
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At the time of TPS referral, patients in the ACT group were taking high doses of opioid medication-well above the 90 mg MED maximum upper limit recommended by the 2017 Canadian guideline for opioids for chronic non-cancer pain.
“At the time of TPS referral, patients in the ACT group were taking high doses of opioid medication—well above the 90 mg MED maximum upper limit recommended by the 2017 Canadian guideline for opioids for chronic non-cancer pain.45”
From Acceptance and Commitment Therapy to manage pain and opioid use after major surgery: Preliminary outcomes from the Toronto General Hospital Transitional Pain Service (2017) · cites this paper as [45]
Recommendation 6 recommends prescribing less than 90 mg morphine equivalents daily, but specifically for patients beginning opioid therapy. It also allows that some patients may benefit from more than 90 mg, so the claim overstates the recommendation as an unqualified maximum. The ACT patients’ doses are the citing authors’ observation, not a finding attributed to this guideline. (LLM, conf=0.88)
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“compared with patients with CNCP .(18,19) Within included studies, we identified a subset of studies with a new user study design to examine transitions to LTOT from an opioid-naïve state, defined using a washout period, or the period of time before the index date without any opioid use.”
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“Four recent national (Canada, France, Germany, USA; Busse et al., 2017; Dowell et al., 2016; Moisset & Martinez, 2016; Häuser et al., 2020) guidelines on opioids for CNCP were provided to the members of the TF by the evidence synthesis team to inform the process.”
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“We excluded (1) non-human or preclinical trials; (2) nonEnglish language trials; (3) trials reporting on acute or cancerrelated pain; (4) trials with less than 24-hours follow-up; (5) trials only reported as abstracts or posters, with no available full-text article; (6) pilot trials where patients overlapped with thos…”
MethodHartford, L. B., Koughnett, J. A. V., Murphy, P., Vogt, K., Hilsden, R., Clarke, C. F. M., Allen, L. J., Gray, S. D., Parry, N. G., Gray, D., et al. (2018) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2018.09.008 · Cited by 103 · see citing works
“Recent guidelines have advocated for a multimodal approach to reduce opioid use in the treatment of acute pain.(14,15) Physician and patient education, smaller opioid prescriptions, non-opioid analgesic medications and improvement of appropriate opioid disposal have all been proposed recently as strategies to combat t…”
Antoniou, T., Ala‐Leppilampi, K., Shearer, D., Parsons, J. A., Tadrous, M., & Gomes, T. (2019) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2019.01.015 · Cited by 102 · see citing works
How to Interpret and Use a Clinical Practice Guideline or Recommendation
Brignardello‐Petersen, R., Carrasco‐Labra, A., & Guyatt, G. H. (2021) · JAMA · doi:10.1001/jama.2021.15319 · Cited by 102 · see citing works
Self-citationAbid Azam, M., Weinrib, A. Z., Montbriand, J., Burns, L. C., McMillan, K., Clarke, H., & Katz, J. (2017) · Canadian Journal of Pain · doi:10.1080/24740527.2017.1325317 · Cited by 90 · see citing works
“Canadian guideline for opioids for chronic non-cancer pain.(45) To change this clinical picture and bring opioid dosing for “legacy patients” in line with current guidelines, empirically supported behavioral protocols are”
BackgroundBialas, P., Maier, C., Klose, P., & Häuser, W. (2019) · European Journal of Pain · doi:10.1002/ejp.1496 · Cited by 92 · see citing works
“The average dosages reported ranged between 40 and 100 morphine equivalent/day support the recommended dosages of recent US and Canadian guidelines (Busse et al., 2017; Dowell et al., 2016).”
BackgroundKatz, J., Weinrib, A. Z., & Clarke, H. (2019) · Canadian Journal of Pain · doi:10.1080/24740527.2019.1574537 · Cited by 87 · see citing works
Darville, R., Lomanowska, A. M., Yu, H., Jobin, P. G., Rosenbloom, B. N., Gabriel, G., Daudt, H., Negraeff, M., Renna, T. D., Hudspith, M., et al. (2023) · Canadian Journal of Pain · doi:10.1080/24740527.2023.2266751 · Cited by 85 · see citing works
“27 However, in the perioperative setting, patients are often discharged with doses exceeding these recommendations.”
BackgroundPredictors of persistent prescription opioid analgesic use among people without cancer in Australia
Lalic, S., Gisev, N., Bell, J. S., Korhonen, M. J., & Ilomäki, J. (2018) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.13556 · Cited by 84 · see citing works
Sommer, C., Klose, P., Welsch, P., Petzke, F. W., & Häuser, W. (2019) · European Journal of Pain · doi:10.1002/ejp.1494 · Cited by 83 · see citing works
“Recent evidence-based guidelines recommended to restrict the dosage for long-term opioid therapy to 90 mg morphine equivalente (MEQ)/d (Busse et al., 2017; Dowell, Haegerich, & Chou, 2016), 120 mg MEQ/d (Häuser et al.”
BackgroundZeraatkar, D., Cooper, M. A., Agarwal, A., Vernooij, R. W. M., Leung, G., Loniewski, K., Dookie, J., Ahmed, M. M., Hong, B. Y., Hong, C. J. H., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054282 · Cited by 83 · see citing works
Self-citationTYNDALL, M. W. (2018) · Canadian Medical Association Journal · doi:10.1503/cmaj.171060 · Cited by 80 · see citing works
Fischer, B., Vojtila, L., & Rehm, J. T. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.11.001 · Cited by 76 · see citing works
High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews
Els, C., Jackson, T., Hagtvedt, R., Kunyk, D., Sonnenberg, B., Lappi, V. G., & Straube, S. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012299.pub2 · Cited by 75 · see citing works
“…equivalent per day as a “watchful dose” (Canadian guideline 2010); of note, since we started the present overview project, this guideline has now been updated and the current Canadian guideline makes reference to recommended dose limits of 90 mg and 50 mg morphine equivalent per day (Busse 2017).”
BackgroundPasricha, S. V., Tadrous, M., Khuu, W., Juurlink, D. N., Mamdani, M., Paterson, J. M., & Gomes, T. (2018) · Pain · doi:10.1097/j.pain.0000000000001242 · Cited by 72 · see citing works
“In turn, recently published clinical practice guidelines for chronic noncancer pain management recommended nonopioid alternatives as first-line and have suggested threshold doses for patients newly started on opioids.(1,6) However, opioids are prescribed for a range of acute and chronic pain conditions, including arth…”
BackgroundSelf-citationThe pharmacological management of chronic lower back pain
Migliorini, F., Maffulli, N., Eschweiler, J., Betsch, M., Catalano, G., Driessen, A., Tingart, M., & Baroncini, A. (2020) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2020.1817384 · Cited by 74 · see citing works
PEER simplified chronic pain guideline
Korownyk, C. S., Montgomery, L. S., Young, J. C., Moore, S., Singer, A. G., MacDougall, P., Darling, S., Ellis, K., Myers, J., Rochford, C., et al. (2022) · Canadian Family Physician · doi:10.46747/cfp.6803179 · Cited by 72 · see citing works
Schofield, P., Dunham, M., Martin, D., Bellamy, G., Francis, S., Sookhoo, D., Bonacaro, A., Hamid, E., Chandler, R. C., Abdulla, A., et al. (2020) · British Journal of Pain · doi:10.1177/2049463720976155 · Cited by 67 · see citing works
Petzke, F. W., Klose, P., Welsch, P., Sommer, C., & Häuser, W. (2019) · European Journal of Pain · doi:10.1002/ejp.1519 · Cited by 65 · see citing works
“…on long-term opioid treatment for non-cancer pain recommended to restrict the dosage for long-term opioid therapy to 90 mg morphine equivalent (MEQ)/d (Busse et al., 2017; Dowell, Haegerich, & Chou, 2016), 120 mg MEQ/d (Häuser et al., 2015 a) and 150 mg MEQ/d (Moisset & Martinez, 2016).”
BackgroundPhillips, M., Vannabouathong, C., Devji, T., Patel, R., Gomes, Z., Patel, A., Dixon, M., & Bhandari, M. (2020) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-019-05763-1 · Cited by 65 · see citing works
Webster, F., Rice, K., Katz, J. D., Bhattacharyya, O. K., Dale, C., & Upshur, R. E. G. (2019) · PLoS ONE · doi:10.1371/journal.pone.0215148 · Cited by 64 · see citing works
Rice, D., Corace, K., Wolfe, D., Esmaeilisaraji, L., Michaud, A., Grima, A., Austin, B., Douma, R., Barbeau, P., Butler, C., et al. (2020) · PLOS ONE · doi:10.1371/journal.pone.0244401 · Cited by 64 · see citing works
Desveaux, L., Saragosa, M., Kithulegoda, N., & Ivers, N. M. (2019) · BMC Family Practice · doi:10.1186/s12875-019-0947-2 · Cited by 62 · see citing works
Management of osteoarthritis of the knee in younger patients
Khan, M., Adili, A. F., Winemaker, M., & Bhandari, M. (2018) · Canadian Medical Association Journal · doi:10.1503/cmaj.170696 · Cited by 61 · see citing works
Dassieu, L., Kaboré, J., Choinière, M., Arruda, N., & Roy, É. (2019) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2019.03.023 · Cited by 60 · see citing works
Dassieu, L., Heino, A., Develay, É., Kaboré, J., Pagé, M. G., Moor, G., Hudspith, M., & Choinière, M. (2021) · Canadian Journal of Pain · doi:10.1080/24740527.2021.1881886 · Cited by 60 · see citing works
“” These guidelines typically promote opioid tapering or cessation and advise against long-term opioid prescription to prevent risks of dependence and serious adverse events such as overdoses.(5,6) This new era of “opioid pharmacovigilance”(7) is catalyzing major changes in the medical management of people living with…”
BackgroundZortéa, M., Ramalho, L., Alves, R. L., Alves, C. F. D. S., Braulio, G., Torres, I. L. D. S., Fregni, F., & Caumo, W. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.01218 · Cited by 57 · see citing works
“, depression and anxiety) and to have a history of another dependence (Busse et al., 2017).”
BackgroundInfluentialEvidence-based guidelines for the pharmacological treatment of migraine
Ornello, R., Caponnetto, V., Ahmed, F., Al‐Khazali, H. M., Ambrosini, A., Ashina, S., Baraldi, C., Bellotti, A., Brighina, F., Calabresi, P., et al. (2025) · Cephalalgia · doi:10.1177/03331024241305381 · Cited by 65 · see citing works
Trends of Opioid Utilisation in Denmark: A Nationwide Study
Nissen, S. K., Pottegård, A., & Ryg, J. (2019) · Drugs - Real World Outcomes · doi:10.1007/s40801-019-00163-w · Cited by 54 · see citing works
Chronic pain diagnoses and opioid dispensings among insured individuals with serious mental illness
Owen-Smith, A., Stewart, C., Sesay, M. M., Strasser, S. M., Yarborough, B. J., Ahmedani, B., Miller-Matero, L. R., Waring, S. C., Haller, I. V., Waitzfelder, B. E., et al. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-2456-1 · Cited by 54 · see citing works
“Healthcare providers should be especially conservative in prescribing opioids for individuals with mental illness – or avoid opioid therapy altogether for this population, consistent with the current Canadian Medical Association recommendation [66] – and instead, favor non-pharmacological alternatives [16] such as beh…”
BackgroundJeddi, H. M., Busse, J. W., Sadeghirad, B., Levine, M., Zoratti, M. J., Wang, L., Noori, A., Couban, R., & Tarride, J. (2024) · BMJ Open · doi:10.1136/bmjopen-2022-068182 · Cited by 54 · see citing works
Self-citationHäuser, W., Schubert, T., Scherbaum, N., & Tölle, T. R. (2017) · Pain · doi:10.1097/j.pain.0000000000001067 · Cited by 51 · see citing works
“In Germany, the MEQ/d requiring attention is 120 mg/d(16) and that for Canada is 90 mg/d.(3) The recommendations for threshold doses of MEQ/d were based for all 3 guidelines on (1) lack of evidence for a dosedependent efficacy of opioids, (2) evidence for negative health outcomes associated with LTOT including overdos…”
BackgroundWiercigroch, D., Sheikh, H., & Hulme, J. (2020) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-019-0250-1 · Cited by 51 · see citing works
“5% risk of addiction, are still widely prescribed [3] and opioid-related deaths continue to rise in Canada [4].”
BackgroundBath, B. L., Lawson, J., Ma, D., & Trask, C. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3790-6 · Cited by 49 · see citing works
Pain polymorphisms and opioids: An evidence based review
Vieira, C., Fragoso, R. M., Pereira, D., & Medeiros, R. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.9792 · Cited by 49 · see citing works
“Another factor that must be considered, when assessing opioid responses, is that several opioids including codeine, tramadol, oxycodone and hydrocodone are affected by variations in metabolism, mediated by cytochrome P450 enzyme CYP2D6, resulting in unpredictable effects in individuals (18,28).”
BackgroundCanadian Guidelines on Opioid Use Disorder Among Older Adults
Rieb, L. M., Samaan, Z., Furlan, A. D., Rabheru, K., Feldman, S., Hung, L., Budd, G., & Coleman, D. (2020) · Canadian Geriatrics Journal · doi:10.5770/cgj.23.420 · Cited by 49 · see citing works
Sihota, A., Smith, B. K., Ahmed, S., Bell, A., Blain, A., Clarke, H. A., Cooper, Z. D., Cyr, C., Daeninck, P. J., Deshpande, A., et al. (2020) · International Journal of Clinical Practice · doi:10.1111/ijcp.13871 · Cited by 49 · see citing works
“The timeline for the frequency of dose reduction is broad to allow for patient tailoring, and is similar to previously published opioid tapering recommendations.(1,3) More recently, the U.”
The Deepening Opioid Crisis in North America: Historical Context and Current Solutions
Donroe, J. H., Socias, M. E., & Marshall, B. D. L. (2018) · Current Addiction Reports · doi:10.1007/s40429-018-0228-5 · Cited by 49 · see citing works
Rahman, Q. A., Janmohamed, T., Pirbaglou, M., Ritvo, P., Heffernan, J. M., Clarke, H. A., & Katz, J. D. (2017) · JMIR mhealth and uhealth · doi:10.2196/mhealth.7871 · Cited by 47 · see citing works
“By tracking opioid use and pain severity over the next several years we will be in a position to provide important Manage My Pain user data on the extent to which the new opioid prescribing guidelines in the United States [34] and Canada [35] are associated with changes in these parameters.”
BackgroundMacCallum, C. A., Eadie, L., Barr, A. M., Boivin, M. R., & Lu, S. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.633168 · Cited by 47 · see citing works
“Opioid-use disorder, overdose, diversion, and escalating doses with opioid tolerance are associated with significant morbidity and mortality (Jones et al., 2015; Busse et al., 2017; Jones et al., 2018; Zhou et al., 2020).”
BackgroundMethodInfluentialStrayer, R. J., Hawk, K. F., Hayes, B. D., Herring, A. A., Ketcham, E. M., LaPietra, A. M., Lynch, J. J., Motov, S. M., Repanshek, Z. D., Weiner, S. G., et al. (2020) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2019.12.034 · Cited by 47 · see citing works
Welsch, P., Petzke, F. W., Klose, P., & Häuser, W. (2019) · European Journal of Pain · doi:10.1002/ejp.1522 · Cited by 46 · see citing works
“…is considered, the recommended dosages of recent evidence-based guidelines on long-term opioid treatment for non-cancer pain should be followed which range between 90 mg morphine equivalent (MEQ)/d (Busse et al., 2017; Dowell, Haegerich, & Chou, 2016) and 150 mg MEQ/day (Moisset & Martinez, 2016).”
BackgroundGoldstein, K., Jones, C., Kay, J., Shin, J. J., & de SA, D. L. (2021) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2021.10.001 · Cited by 45 · see citing works
Karamouzian, M., Rafat, B., Kolla, G., Urbanoski, K. A., Atkinson, K. A., Bardwell, G., Bonn, M., Touesnard, N., Henderson, N., Bowles, J. M., et al. (2023) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2023.104157 · Cited by 44 · see citing works
Evidence-based medicine and precision medicine: Complementary approaches to clinical decision-making
Chow, N., Gallo, L., & Busse, J. W. (2018) · Precision Clinical Medicine · doi:10.1093/pcmedi/pby009 · Cited by 44 · see citing works
Self-citationFarrell, B. J., Conklin, J., Dolovich, L. R., Irving, H. R., Maclure, M., McCarthy, L. M., Moriarty, F., Pottie, K. C., Raman‐Wilms, L., Reeve, E., et al. (2018) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2018.08.010 · Cited by 44 · see citing works
Kurteva, S., Abrahamowicz, M., Gomes, T., & Tamblyn, R. M. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.8782 · Cited by 43 · see citing works
Feehan, A. K., Morgenweck, J., Zhang, X. Y., Amgott-Kwan, A. T., & Zadina, J. E. (2017) · Journal of Pain · doi:10.1016/j.jpain.2017.08.007 · Cited by 42 · see citing works
Škvarč, N. K., Morlion, B. J., Vowles, K. E., Bannister, K., Buchsner, E., Casale, R., Chenot, J., Chumbley, G. M., Drewes, A. M., Dom, G., et al. (2021) · European Journal of Pain · doi:10.1002/ejp.1744 · Cited by 44 · see citing works
Yang, M. M. H., Riva-Cambrin, J. K., Cunningham, J., Jetté, N., Sajobi, T. T., Soroceanu, A., Lewkonia, P. D., Jacobs, W. B., & Casha, S. (2020) · Journal of Neurosurgery Spine · doi:10.3171/2020.5.spine20347 · Cited by 41 · see citing works
Meng, H., Pagé, M. G., Ajrawat, P., Deshpande, A., Samman, B., Dominicis, M., Ladha, K. S., Fiorellino, J., Huang, A., Kotteeswaran, Y., et al. (2021) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-020-01903-1 · Cited by 39 · see citing works
McEachern, J., Adye-White, L., Priest, K. C., Moss, E., Gorfinkel, L., Wood, E., Cullen, W., & Klimas, J. (2018) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2018.08.006 · Cited by 38 · see citing works
“Most trials involving chronic pain patients often specifically exclude people with substance use disorders (Busse et al., 2017).”
BackgroundAssociations Between Opioid Prescribing Patterns and Overdose Among Privately Insured Adolescents
Groenewald, C. B., Zhou, C., Palermo, T. M., & Cleve, W. V. (2019) · PEDIATRICS · doi:10.1542/peds.2018-4070 · Cited by 38 · see citing works
Cannabis for pain in orthopedics: a systematic review focusing on study methodology
Madden, K., George, A., van der Hoek, N., Borim, F. M., Mammen, G., & Bhandari, M. (2019) · Canadian Journal of Surgery · doi:10.1503/cjs.001018 · Cited by 38 · see citing works
Osborne, S. R., Piper, D. A., Alston, L. V., Bolton, K. A., Whelan, J., Reeve, E., Shee, A. W., Browne, J., Walker, T., Versace, V. L., et al. (2020) · The Medical Journal of Australia · doi:10.5694/mja2.50881 · Cited by 43 · see citing works
What interventions are effective to taper opioids in patients with chronic pain?
Sandhu, H. K., Underwood, M. R., Furlan, A. D., Noyes, J., & Eldabe, S. S. (2018) · BMJ · doi:10.1136/bmj.k2990 · Cited by 37 · see citing works
Applications for pharmacogenomics in pharmacy practice: A scoping review
Hayashi, M., Hamdy, D. A., & Mahmoud, S. H. (2021) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2021.08.009 · Cited by 38 · see citing works
Depression in chronic pain: might opioids be responsible?
Mazereeuw, G., Sullivan, M. D., & Juurlink, D. N. (2018) · Pain · doi:10.1097/j.pain.0000000000001305 · Cited by 35 · see citing works
Self-citationA Systematic Review of Behavioral Interventions to Decrease Opioid Prescribing After Surgery
Zhang, D. D. Q., Sussman, J., Dossa, F., Jivraj, N. K., Ladha, K. S., Brar, S., Urbach, D. R., Tricco, A. C., Wijeysundera, D. N., Clarke, H. A., et al. (2019) · Annals of Surgery · doi:10.1097/sla.0000000000003483 · Cited by 35 · see citing works
Sharma, V., Weir, D. L., Samanani, S., Simpson, S. H., Gilani, F., Jess, E., & Eurich, D. T. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-030858 · Cited by 35 · see citing works
“IntErPrEtAtIOn Many reputable clinical resources indicate that benzodiazepine receptor modulators should not be combined with opioids, yet this study showed that nearly 20% of patients using an opioid did so in combination with a benzodiazepine receptor modulator in Alberta.(1) 14 15 Those on >90 mg OME had the highes…”
InfluentialPain management with opioids in adults
Montgomery, L. S. (2020) · Journal of Neuroscience Research · doi:10.1002/jnr.24695 · Cited by 37 · see citing works
“Current Canadian practice guidelines situate opioids as a potential option for patients who have tried all other evidence-based therapies and lack major risk factors for OUD or severe opioid toxicity (Busse et al., 2017).”
BackgroundCampbell, G., Noghrehchi, F., Nielsen, S., Clare, P. J., Bruno, R., Lintzeris, N., Cohen, M. L., Blyth, F., Hall, W., Larance, B., et al. (2020) · EClinicalMedicine · doi:10.1016/j.eclinm.2020.100592 · Cited by 36 · see citing works
“Introduction In the past two decades, there has been a dramatic increase in long-term opioid prescribing for chronic non-cancer pain (CNCP) in the United States [1], Canada [2], the United Kingdom [3] and Australia [4].”
BackgroundLong-term opioid therapy for chronic noncancer pain: second update of the German guidelines
Petzke, F. W., Bock, F., Hüppe, M., Nothacker, M., Norda, H., Radbruch, L., Schiltenwolf, M., Schüler, M., Tölle, T. R., Viniol, A., et al. (2020) · PAIN Reports · doi:10.1097/pr9.0000000000000840 · Cited by 34 · see citing works
“With the objective to help mitigate the opioid crisis in North America, Canadian guidelines for opioid therapy and CNCP were updated in 2017.(4) In contrast to the 2010 version,(14) in which most statements supported the prescribing of opioids, 7 of 10 recommendations of the 2017 version focussed on harm reduction.”
BackgroundCross, A. J., Buchbinder, R., Mathieson, S., Bourne, A., Maher, C. G., Lin, C. C., & O’Connor, D. A. (2022) · BMJ Quality & Safety · doi:10.1136/bmjqs-2021-014186 · Cited by 34 · see citing works
Tapering opioids: a comprehensive qualitative review
Davis, M. P., Digwood, G., Mehta, Z., & McPherson, M. L. (2020) · Annals of Palliative Medicine · doi:10.21037/apm.2019.12.10 · Cited by 33 · see citing works
“For slow tapers, the general rule is that the duration of the taper should be proportional to the duration of the opioid therapy (163).”
BackgroundSelfridge, M., Card, K. G., Kandler, T., Flanagan, E., Lerhe, E., Heaslip, A., Nguyen, A., Moher, M., Pauly, B., Urbanoski, K. A., et al. (2022) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2022.103709 · Cited by 32 · see citing works
Patient Values and Preferences Regarding Opioids for Chronic Noncancer Pain: A Systematic Review
Goshua, A., Craigie, S., Guyatt, G. H., Agarwal, A., Li, R., Bhullar, J. S., Scott, N., Chahal, J., Pavalagantharajah, S., Chang, Y., et al. (2017) · Pain Medicine · doi:10.1093/pm/pnx274 · Cited by 31 · see citing works
Self-citationGomes, T., Khuu, W., Craiovan, D., Martins, D., Hunt, J., Lee, K., Tadrous, M., Mamdani, M., Paterson, J. M., & Juurlink, D. N. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.06.028 · Cited by 31 · see citing works
Self-citationPainful lives: Chronic pain experience among people who use illicit drugs in Montreal (Canada)
Dassieu, L., Kaboré, J., Choinière, M., Arruda, N., & Roy, É. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.112734 · Cited by 31 · see citing works
- Authors
- Busse, J. W., Craigie, S., Juurlink, D. N., Buckley, D. N., Wang, L., Couban, R. J., Agoritsas, T., Akl, E. A., Carrasco-Labra, A., Cooper, L., Cull, C., da Costa, B. R., Frank, J. W., Grant, G., Iorio, A., Persaud, N., Stern, S., Tugwell, P., Vandvik, P. O., & Guyatt, G. H.
- Affiliations
- University of Bern (CH)
- ORCID
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2017-05-07
- Volume
- 189
- Issue
- 18
- Pages
- E659-E666
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC5422149
- OpenAlex
- W2612284626
- Cited by
- 707
- References
- 50
- Citations by year
- 2026: 37 · 2025: 58 · 2024: 71 · 2023: 59 · 2022: 82 · 2021: 107 · 2020: 105 · 2019: 86 · 2018: 67 · 2017: 29 · 2016: 3 · 2012: 1
- FWCI
- 73.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- BORIS (University Library Bern) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (IK2 HX001914)
- 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 therapy, chronic non-cancer pain, pain management, opioid prescribing
- MeSH terms
- Analgesics, Opioid, Dose-Response Relationship, Drug, Humans, Opioid-Related Disorders, Pain Measurement, Primary Health Care, Treatment Outcome, Drug Monitoring, Chronic Pain
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