Abstract
In the US, the 1980s and 1990s were a period of renewed interest in the use of opioids, particularly for the palliation of patients with malignancy or terminal illness, but also for the treatment of chronic, non-terminal pain. However, as the number of prescription opioid overdose deaths rose, the medical profession was compelled to take a more systematic look at the risks and benefits of long-term opioid use. Three consecutive systematic reviews—by the American Pain Society in 2009, the Agency for Healthcare Research and Quality in 2014, and the Centers for Disease Control and Prevention in 2016—brought to light the mounting evidence for adverse outcomes associated with long-term opioid use, as well as the paucity of evidence for long-term benefit.
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