Major Risks of Long-Term Opioid Tx Deemed Dose-Dependent
(HealthDay News) — The long-term effectiveness and harms of opioids for chronic pain are unclear, although the evidence supports a dose-dependent risk for serious harms, according to a review published online January 13 in the Annals of Internal Medicine.
Roger Chou, MD, from the Oregon Health & Sciences University in Portland, and colleagues conducted a systematic review to examine the effectiveness and harms of long-term opioid therapy for chronic pain in adults. Data were included from randomized trials and observational studies that involved adults with chronic pain.
The researchers found that no studies of opioid versus no opioid therapy assessed long-term pain, function, quality of life, opioid abuse, or addiction outcomes. Increased risk of overdose, opioid abuse, fractures, myocardial infarction, and markers of sexual dysfunction were seen in association with opioid therapy in good- and fair-quality observational studies; few studies were seen for each of these outcomes. Higher doses correlated with increased risk for some harms. Limited evidence was available on the effectiveness and harms of different opioid dosing and risk mitigation strategies.
"Evidence is insufficient to determine the effectiveness of long-term opioid therapy for improving chronic pain and function," the authors write. "Evidence supports a dose-dependent risk for serious harms."
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.