Get CT Greenwich Health Long Term Opioid Therapy For The Treatment Of Non-cancer Pain Opioid Contract /

Opioids should be used only when benefits for pain and function are expected to outweigh risks. Before starting opioids, clinicians should establish treatment goals with patients and consider how opioids will be discontinued if benefits do not outweigh risks.

However, evidence shows that for most patients with chronic non-cancer pain opioids do not provide clinically important improvement in pain or function compared with placebo. In contrast, they carry significant risk of harm; around 80% of people taking opioids for 3 months or more experience harms.

The 4 A's—analgesia, activities of daily living, adverse events, and aberrant drug-taking behaviors—can structure assessment and serve as a means by which to record patient response to therapy.

These side effects include nausea, respiratory depression, acute tolerance and opioid induced hyperalgesia. (Hyperalgesia being defined as an increased response to a stimulus which is normally painful.)

Direct risks of long-term opioid therapy are not limited to opioid addiction and overdose. Potential medical risks include serious fractures, breathing problems during sleep, hyperalgesia, immunosuppression, chronic constipation, bowel obstruction, myocardial infarction, and tooth decay secondary to xerostomia.

Although the threshold of long-term opioid therapy has ranged from one week to one year, most of the previous studies had used ≥90 days of continuous opioid therapy to define long-term opioid use.

Opioids are not the most effective treatment for long-term, non-cancer pain. In fact, opioids are no longer recommended for the treatment of most patients with chronic pain. If prescription opioids are used, you will be given information on possible side effects, other risks, and monitoring needed for your safety.

Opioids can be an effective component of the management of acute and cancer-related pain. However, evidence shows that for most patients with chronic non-cancer pain opioids do not provide clinically important improvement in pain or function compared with placebo.