Expert Commentary

APS/AAPM Guidelines for Opioids in Chronic Noncancer Pain

Roger Chou, MD

General Medicine Internist
Oregon Health & Science University
Director of Clinical Guidelines Development
American Pain Society (APS)
Portland, Oregon

Opioids are an invaluable class of analgesics for acute pain, pain associated with such terminal conditions as cancer, and chronic noncancer pain. The lack of studies evaluating comparative effectiveness and risk during long-term treatment in varied populations and recent increases in prescription opioid abuse, however, necessitate an iterative, structured approach to patient selection, risk stratification, and long-term monitoring of patients outcomes. To aide in this process, the American Pain Society and American Academy of Pain Medicine have recently published guidelines for the use of opioids in noncancer pain. These guidelines stress the importance of applying evidence-based medicine, whenever possible, defining patient-specific treatment goals (eg, pain relief, improved function, better social interactions), and assessing outcomes in relation to these goals to evaluate the effectiveness of the opioid-based treatment regimen.
 

References

  1. Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10:113-130.
  2. Chou R, Fanciullo GJ, Fine PG, et al. Opioids for chronic noncancer pain: prediction and identification of aberrant drug-related behaviors: a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10:131-146.
  3. Chou R, Ballantyne JC, Fanciullo GJ, Fine PG, Miaskowski C. Research gaps on use of opioids for chronic noncancer pain: findings from a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10(2):147-59.

 

 

 

Add comment

[ submit ]

View AllRelated Videos
Addiction in Patients With Chronic Pain - Michael R. Clark, MD, MPH, MBA, Joyce King, MD, and Glenn J. Treisman, MD, PhD Addiction in Patients With Chronic Pain
Michael R. Clark, MD, MPH, MBA, Joyce King, MD, and Glenn J. Treisman, MD, PhD
Central Neuromodulation for Chronic Pain: Invasive and Noninvasive Techniques - Ricardo Cruciani, MD, PhD Central Neuromodulation for Chronic Pain: Invasive and Noninvasive Techniques
Ricardo Cruciani, MD, PhD
Drug Testing and Reimbursement for Patients with Chronic Pain - Jennifer Bolen Drug Testing and Reimbursement for Patients with Chronic Pain
Jennifer Bolen
An Overview of Buprenorphine - Jeffrey A. Gudin, MD An Overview of Buprenorphine
Jeffrey A. Gudin, MD
View AllPublications
Chronic opioid therapy and preventive services in rural primary care: an Oregon rural practice-based research network study.
Buckley DI, Calvert JF, Lapidus JA, et al.
Ann Fam Med. 2010;8(3):237-44.
PURPOSE:...
A different kind of co-morbidity: Understanding posttraumatic stress disorder and chronic pain
Beck JG, Clapp JD.
Psychol Trauma. 2011 Jun;3(2):101-108.
Many traumatic events leave...
The impact of enrollment in a specialized interdisciplinary neuropathic pain clinic
Garven A, Brady S, Wood S, Hatfield M, Bestard J, Korngut L, Toth C.
Pain Res Manag. 2011...
Association between urine drug test results and treatment outcome in high-risk chronic pain patients on opioids
Barth KS, Becker WC, Wiedemer NL, Mavandadi S, Oslin DW, Meghani SH, Gallagher RM.
J Addict...
The role of core strengthening for chronic low back pain.
Akuthota V, Standaert CJ, Chimes GP.
PM R. 2011 Jul;3(7):664-70.
Clinician.com Links
  • SLEEPClinician.com
  • IDClinician.com
  • PSYCHClinician.com
  • CARDIOVASCULARClinician.com
  • PrimaryCAREClinician.com
  • Stop Pain.org