From the Guidelines
Opioids are not a good long-term option for chronic pain management outside of active cancer, palliative, and end-of-life care, due to their small to moderate short-term benefits, uncertain long-term benefits, and potential for serious harms. When considering opioid therapy, clinicians should weigh the expected benefits against risks and consider nonpharmacologic and nonopioid pharmacologic therapies as preferred options 1. The CDC guideline for prescribing opioids for chronic pain recommends that opioids should not be considered first-line or routine therapy for chronic pain, given their potential for serious harms and uncertain long-term benefits 1.
Key Considerations
- Nonpharmacologic therapy, such as exercise therapy and cognitive-behavioral therapy (CBT), and nonopioid pharmacologic therapy, such as NSAIDs and acetaminophen, should be used to reduce pain and improve function in patients with chronic pain 1.
- Opioids should be combined with nonpharmacologic and nonopioid pharmacologic therapy, as appropriate, to provide greater benefits to patients 1.
- Clinicians should establish treatment goals with patients, including realistic goals for pain and function, and consider how opioid therapy will be discontinued if benefits do not outweigh risks 1.
- The American Society of Clinical Oncology clinical practice guideline recommends that clinicians should assess the potential risks and benefits when initiating treatment that will incorporate long-term use of opioids 1.
Clinical Decision-Making
When making decisions about long-term opioid use, clinicians should consider the individual patient's characteristics, medical history, and treatment goals. They should also discuss potential benefits and risks with patients and consider alternative therapies. The goal of treatment should be to improve both pain relief and function, and clinicians should use validated instruments to track patient outcomes 1. In general, opioids should be used with caution and only when the benefits outweigh the risks, and clinicians should be prepared to discontinue opioid therapy if it is not effective or if the risks outweigh the benefits.
From the Research
Opioid Long-Term Option
There are no research papers to assist in answering this question, as the provided studies focus on beta-blockers, hypertension, and diabetes, with no mention of opioids.
- The studies 2, 3, 4, 5, 6 discuss the use of beta-blockers in managing hypertension and diabetes, but do not address opioids.
- None of the studies provide information on the long-term use of opioids, their benefits, or their risks.
- The available evidence does not support the discussion of opioids as a long-term option, as it is outside the scope of the provided research papers.