With all the courses and Physician college emphasis on opioid addiction detection one would think addiction was highly likely on opioids – a Cochrane review finds quite the opposite.
Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006605.
Long-term opioid management for chronic noncancer pain.
Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, Schoelles KM.
abstract here
Their summation:
“Because most studies screened out potential participants with histories of substance abuse or addiction, the rates of addiction reported in these studies are only generalizable to patients without a history of addictive/abusive behaviors. This finding is consistent
with that of another review article on opioid abuse and addiction that calculated an abuse/addiction rate of 0.19% in studies that prescreened chronic pain patients for long-term opioid use or addiction/ abuse history, and 3.27% in all studies (Fishbain 2008).”
This means pre-screening and a useful tool was previously mentioned:
simple opioid risk tool here
Comment – the review case doubt whether chronic opioids are that effective as well. It would be nice if more time was spent on teaching doctors on how to manage chronic pain rather than witch hunting for opioid overuse and depending solely on opioids to manage pain.
Any comments?
Nice to see this coming out in a Cochrane review.. that will be hard to argue against!