Chronic Pain, Chronic Opioid Addiction: a Complex Nexus

Area of Science:

• Pain Management
• Addiction Medicine
• Pharmacology

Background:

• Opioid prescribing has significantly increased over the last two decades.
• This rise is associated with escalating rates of opioid addiction and overdose fatalities.
• Chronic opioid therapy (COT) is frequently used for chronic non-cancer pain (CNCP).

Purpose of the Study:

• To review the evidence on the effectiveness of COT for CNCP.
• To assess the risk of developing opioid use disorder (OUD) in patients on COT.
• To highlight the importance of proper patient assessment and monitoring.

Main Methods:

• Literature review of studies on COT for CNCP.
• Analysis of data regarding the incidence of OUD and aberrant drug-related behaviors (ADRBs).

Main Results:

• Rates of OUD development in patients on COT range widely from 0% to 50%.
• Aberrant drug-related behaviors (ADRBs) are reported in approximately 20% of patients.
• Evidence for long-term effectiveness of COT for CNCP is variable.

Conclusions:

• Healthcare providers must carefully assess and screen patients considered for COT.
• Continuous monitoring of patients on COT is crucial for managing risks.
• Evidence-based tools should be utilized for patient management to mitigate OUD and ADRBs.