Chronic pain treatment with opioid analgesics: benefits versus harms of long-term therapy
Abstract
Chronic non-cancer pain (CNCP) is a disabling chronic condition with a high prevalence rate around the world. Opioids are routinely prescribed for treatment of chronic pain (CP). In the past two decades there has been a massive increase in the number of opioid prescriptions, prescribed daily opioid doses and overall opioid availability. Many more patients with CNCP receive high doses of long-acting opioids on a long-term basis. Yet CP and related disability rates remain high, and majority of the patients with CNCP are dissatisfied with their treatments. Intersecting with the upward trajectory in opioid use are the increasing trends in opioid related adverse effects, especially prescription drug abuse, addiction and overdose deaths. This complex situation raises questions on the relevance of opioid therapy in the treatment of CNCP. This article reviews current evidence on opioid effectiveness, the benefits and harms of long-term therapy in CNCP.
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Psychological treatments for pain are expected to produce fewer side effects than medications.
“Psychological treatments for pain are expected to produce fewer side effects then medications”
From Exposure and CBT for chronic back pain: An RCT on differential efficacy and optimal length of treatment (2018) · cites this paper as Sehgal, Colson, & Smith, 2013
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- Authors
- Sehgal, N., Colson, J., & Smith, H. S.
- Affiliations
- University of Wisconsin–Madison (US)
- West Virginia University Hospitals (US)
- Albany Medical College (US)
- Corresponding author
- Sehgal, Nalini
- ORCID
- Sehgal, Nalini
- Venue
- Expert Review of Neurotherapeutics
- Publisher
- Informa UK Limited
- Published
- 2013-11
- Volume
- 13
- Issue
- 11
- Pages
- 1201-1220
- ISSN
- 1473-7175 (ISSN-L)
- 1744-8360
- OpenAlex
- W2162578564
- Cited by
- 79
- References
- 145
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 3 · 2021: 4 · 2020: 3 · 2019: 11 · 2018: 12 · 2017: 7 · 2016: 11 · 2015: 11 · 2014: 5
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Review of Neurotherapeutics (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 › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- chronic non-cancer pain, opioid analgesics, long-term opioid therapy, long-acting opioids, opioid-related harms, prescription drug misuse, opioid use disorder, opioid overdose deaths, opioid prescribing trends, treatment effectiveness
- MeSH terms
- Analgesics, Opioid, Humans, Opioid-Related Disorders, Time Factors, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Assessment, Chronic Pain, Pain Management
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