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Long-term opioid therapy in Denmark: A disappointing journey
H Birke1, O Ekholm2, P Sjøgren1,3
1Department of Oncology, Rigshospitalet Copenhagen University Hospital, Denmark.
European Journal of Pain (London, England)
|May 9, 2017
Summary
Long-term opioid therapy for chronic non-cancer pain (CNCP) patients shows a higher incidence and is linked to negative changes in work and physical activity. Opioid therapy does not appear to improve pain relief or quality of life in these patients.
Area of Science:
- Pain Management
- Public Health
- Pharmacology
Background:
- Longitudinal population-based studies on long-term opioid therapy (L-TOT) for chronic non-cancer pain (CNCP) are limited.
- This study examines L-TOT incidence, predictors, and health outcomes in CNCP patients.
Purpose of the Study:
- Investigate the incidence and predictors of initiating L-TOT in CNCP patients.
- Assess changes in self-rated health, pain interference, and physical activities among long-term opioid users.
- Evaluate the effectiveness of L-TOT in achieving pain relief and functional improvement in a general population.
Main Methods:
- Utilized data from Danish Health and Morbidity Surveys and the Danish National Prescription Registry (2000-2012).
- Followed 12,145 individuals without prior opioid dispensing, with a subsample (n=2015) completing questionnaires in 2000 and 2013.
- Defined L-TOT as dispensing at least one opioid prescription in six separate months within a year.
Main Results:
- Incidence of L-TOT was higher in CNCP patients (9/1000 person-years) versus others (2/1000 person-years).
- Smoking and benzodiazepine use predicted L-TOT initiation in CNCP patients.
- L-TOT in CNCP patients increased negative changes in work interference (OR 9.2) and moderate activities (OR 3.7), with a dose-response relationship observed.
Conclusions:
- Long-term opioid therapy for CNCP patients did not achieve key goals of pain relief, improved quality of life, or functional capacity.
- Opioid therapy in a general population setting for CNCP appears ineffective for pain relief and functional improvement.
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