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Pharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.

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This summary is machine-generated.

Reducing long-term prescription opioid use can be achieved through tapering or opioid agonist treatment (OAT). Both strategies have benefits and drawbacks, with OAT improving clinical outcomes and tapering reducing opioid dosage.

Keywords:
opioid agonist treatmentopioid rotationopioid taperingprescription opioid misuseprescription opioid use disorderprescription opioids

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Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Pain Management

Background:

  • Long-term prescription opioid use is linked to increased health risks.
  • Research on opioid reduction primarily focuses on heroin, not prescription opioids.
  • Understanding pharmacological strategies for prescription opioid reduction is crucial.

Purpose of the Study:

  • To review pharmacological strategies for reducing prescription opioid use.
  • To assess clinical outcomes in individuals with long-term prescription opioid use or opioid use disorder.

Main Methods:

  • Systematic literature search of PubMed, Embase, CINAHL, and Cochrane Library.
  • Included randomized controlled trials and observational studies.
  • Evaluated outcomes such as dose reduction, pain, addiction, and quality of life.

Main Results:

  • Thirteen studies were identified, examining opioid tapering and opioid agonist treatment (OAT).
  • Tapering decreased opioid dosage but had mixed effects on pain and addiction.
  • OAT (buprenorphine/methadone) improved pain and quality of life, with a non-significant preference for methadone in treatment retention.

Conclusions:

  • Both tapering and OAT are viable strategies for prescription opioid management.
  • Tapering reduces opioid dosage but has variable effects on pain and potential adverse events.
  • OAT improves clinical outcomes, offering a suitable alternative when tapering is not feasible.