Reflections on the role of opioids in the treatment of chronic pain: a shared solution for prescription opioid abuse and pain.

Abstract

‘The Role of Opioids in the Treatment of Chronic Pain’ was the title of a recent workshop (September 29–30, 2014) supported by the National Institutes of Health (NIH) Office of Disease Prevention that highlights the relevance and urgency of the topic. High‐quality research presently does not exist to definitively answer questions about opioid safety, efficacy and abuse potential with long‐term use 1. However, prescriptions for opioids increased from 76 million in 1991 to 207 million in 2013, which were associated with parallel increases in opioid‐related morbidity and mortality 2. Currently, in the U.S., close to 100 million Americans suffer from chronic pain and may be given prescription opioids, along with close to two million Americans who abuse opioid analgesics 3, with over 16 000 overdose deaths attributed to prescription opioids 4. This situation reflects both the challenge to effectively treat the complex condition of chronic pain and the lack of understanding about opioid abuse potential and the risk of addiction in healthcare settings.