Is the Therapeutic Use of Opioids Adversely Affected by Prejudice and Law?

Zenz, M.; Sorge, J.

doi:10.1007/978-3-642-84138-5_6

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…Notions such as association with end-of-life care, tolerance, side effects other than addiction and life-limiting properties were of limited concern to the participants in this study, yet they have been discussed through literature as long-standing barriers to analgesia provision [7,11,15,19,22].…”

Section: The Mythology Of Morphinementioning

confidence: 99%

Exploring the myths of morphine in cancer: views of the general practice population

Grant

Ugalde

Vafiadis³

et al. 2014

Support Care Cancer

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The public view of morphine to emerge from this study is markedly different from that discussed in the myths of morphine. It is viewed as a medication that has the ability to provide peace and control both pain and the course of cancer. The participants in this study described a wish for greater involvement in pain control decisions, perceiving morphine as a facilitator rather than a barrier to good cancer care.

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Section: The Mythology Of Morphinementioning

confidence: 99%

Exploring the myths of morphine in cancer: views of the general practice population

Grant

Ugalde

Vafiadis³

et al. 2014

Support Care Cancer

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“…Rather than augmenting patient distress, opioid therapy is widely perceived to be an effective means to temper it and offers the opportunity for better function and quality of life (33,34). On this basis, long term treatment with opioid drugs has been strongly advocated by pain specialists and both national and international medical organizations (31,32,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44).…”

Section: Implications Of Clinical Experience In the Cancer Populationmentioning

confidence: 99%

“…Unfortunately, there is evidence that regulatory policies can contribute to the undertreatment of pain by either impeding access to controlled prescription drugs or negatively influencing prescribing behaviour (40,41,44,46,(49)(50)(51). Impediments to access are exemplified by the existence of regulations in some American states that limit the number of tablets that may be prescribed per prescription.…”

Section: Implications Of Opioid Regulationmentioning

confidence: 99%

Opioid Therapy for Chronic Nonmalignant Pain

Portenoy

1995

Pain Research and Management

123

145

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RK Portenoy.Opioid therapy for chronic nonmalignant pain. Pain Res Manage 1996;1(1):17-28. Long term administration of an opioid drug for chronic nonmalignant pain continues to be controversial, but is no longer uniformly rejected by pain specialists. This is true despite concerns that the regulatory agencies that oversee physician prescribing of opioid drugs continue to stigmatize the practice. The changing clinical perspective has been driven, in part, by widespread acknowledgement of the remarkably favourable outcomes achieved during opioid treatment of cancer pain. These outcomes contrast starkly with popular teaching about chronic opioid therapy and affirm the potential for prolonged efficacy, tolerable side effects, enhanced function associated with improved comfort and minimal risk of aberrant drug-related behaviours consistent with addiction. A large anecdotal experience in populations with nonmalignant pain suggests that these patients are more heterogeneous and that opioid therapy will greatly benefit some and will contribute to negative outcomes for others. The few controlled clinical trials that have been performed support the safety and efficacy of opioid therapy, but have been too limited to ensure generalization to the clinical setting. A critical review of the medical literature pertaining to chronic pain, opioid pharmacology and addiction medicine can clarify misconceptions about opioid therapy and provide a foundation for patient selection and drug administration. The available data support the view that opioids are no panacea for chronic pain, but should be considered in carefully selected patients using clinically derived guidelines that stress a structured approach and ongoing monitoring of efficacy, adverse effects, functional outcomes and the occurrence of aberrant drug-related behaviours. Key Words: Addiction, Drug dependence, Nonmaligant pain, Opioids, Pain therapyThérapie opioïde pour la douleur chronique non cancéreuse RÉSUMÉ : L'administration à long terme d'un médicament opioïde pour traiter la douleur chronique non cancéreuse reste sujet à controverse mais n'est plus rejetée de façon uniforme par les spécialistes de la douleur. Ceci est vrai même si l'on s'inquiète de ce que les organismes régulateurs qui supervisent la prescription médicale d'agents opioïdes persistent à stigmatiser cette pratique. Le changement de perspective clinique a été motivé en partie par une reconnaissance généralisée des résultats remarquablement favorables obtenus lors du traitement opioïde de la douleur cancéreuse. Ces résultats contrastent carrément avec ce qui est généralement enseigné sur l'administration à long terme d'un médicament opioïde et, confirment un potentiel d'efficacité durable, des effets secondaires supportables, une augmentation de la capacité fonctionnelle associée à une amélioration du bienêtre et, un risque minimal de comportements aberrants liés au médicament compatibles avec une toxicomanie. Une vaste expérience anecdotique chez des populations souffrant d'une douleur non cancéreus...

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Selection of analgesic therapies in rheumatoid arthritis the role of opioid medications

Gonzales

Portenoy

1993

Arthritis & Rheumatism

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Is the Therapeutic Use of Opioids Adversely Affected by Prejudice and Law?

Cited by 8 publications

References 5 publications

Exploring the myths of morphine in cancer: views of the general practice population

Exploring the myths of morphine in cancer: views of the general practice population

Opioid Therapy for Chronic Nonmalignant Pain

Selection of analgesic therapies in rheumatoid arthritis the role of opioid medications

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