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Problems with opioids - beyond misuse.

Dorna Kheirabadi1, Deeba Minhas2, Rezvan Ghaderpanah3

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This summary is machine-generated.

Long-term opioid therapy (LTOT) offers no proven benefits for chronic pain patients, despite widespread use. This review highlights numerous serious, lesser-known side effects, urging informed patient-provider discussions on risks versus benefits.

Keywords:
Adverse effectsChronic painLong-term treatmentOpioid related disoredersOpioidsProblems

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Area of Science:

  • Medical Research
  • Pharmacology
  • Public Health

Background:

  • The U.S. faces an opioid epidemic, with millions on long-term opioid therapy (LTOT).
  • Existing research indicates no significant short-term or long-term benefits of LTOT for chronic pain management.
  • Patients often report subjective improvements, but objective outcomes do not differ from non-opioid users.

Purpose of the Study:

  • To identify and raise awareness of less recognized adverse effects associated with LTOT.
  • To facilitate better risk-benefit assessments for healthcare providers and patients considering LTOT.
  • To emphasize the potential harms of prolonged opioid use in chronic pain management.

Main Methods:

  • A scoping review of literature from PubMed and Google Scholar.
  • Keywords included opioids, chronic pain, and specific adverse effects (e.g., hypogonadism, cancer progression, cardiovascular events).
  • Focused on English-language full articles published between January 2018 and April 2023.

Main Results:

  • LTOT is associated with probable serious adverse consequences across multiple body systems.
  • Identified side effects impact endocrine, cardiovascular, renovascular, and neurological functions.
  • Sleep disturbances and mood disorders are also significant concerns.

Conclusions:

  • The lack of demonstrated long-term benefits from LTOT is contrasted by significant potential harms.
  • Healthcare providers must proactively discuss these serious risks with patients.
  • Informed decision-making is crucial when initiating or continuing long-term opioid therapy for chronic pain.