The Prevalence of Opioid Analgesic Use in People with Chronic Noncancer Pain: Systematic Review and Meta-Analysis of Observational Studies

Abstract

Objective To review studies examining the proportion of people with chronic noncancer pain who report consuming opioids and characteristics associated with their use. Design Systematic review. Methods We searched databases from inception to February 8, 2020, and conducted citation tracking. We included observational studies reporting the proportion of adults with chronic noncancer pain who used opioid analgesics. Opioids were categorized as weak (e.g., codeine) or strong (e.g., oxycodone). Study risk of bias was assessed, and Grading of Recommendations Assessment, Development and Evaluations provided a summary of the overall quality. Results were pooled using a random-effects model. Meta-regression determined factors associated with opioid use. Results Sixty studies (N=3,961,739) reported data on opioid use in people with chronic noncancer pain from 1990 to 2017. Of these 46, 77% had moderate risk of bias. Opioid use was reported by 26.8% (95% confidence interval [CI], 23.1–30.8; moderate-quality evidence) of people with chronic noncancer pain. The use of weak opioids (17.3%; 95% CI 11.9–24.4; moderate-quality evidence) was more common than the use of strong opioids (9.8%; 95% CI, 6.8–14.0; low-quality evidence). Meta-regression determined that opioid use was associated with geographic region (P=0.02; lower in Europe than North America), but not sampling year (P=0.77), setting (P=0.06), diagnosis (P=0.34), or disclosure of funding (P=0.77). Conclusions Our review summarized data from over 3.9 million people with chronic noncancer pain reporting their opioid use. Between 1990 and 2017, one-quarter of people with chronic noncancer pain reported taking opioids, and this proportion did not change over time.

Prevalence and correlates of prescription opioid use among US adults, 2019–2020

“…Our estimate for POU prevalence among respondents with chronic pain (29.3%) is slightly higher than the 27% found in a meta-analysis from 60 available studies worldwide using data from various years between late 1990s and 2010s [ 42 ], and much higher than estimates from individual countries outside the US [ 43 – 48 ]. This suggests that prescription opioid use rates among chronic pain patients remain higher in the US than in many other countries.…”

Massage Therapy: A Person-Centred Approach to Chronic Pain

“…These interventions carry a considerable risk for adverse events and, when compared to placebo, have minimal efficacy for people experiencing chronic pain. (13,(15)(16)(17)(18)(19)(20)(21)(22)(23) The current medical landscape and the high impact of chronic pain present a need to develop effective evidence-based strategies. (12,(24)(25)(26)(27) Doing so may require re-evaluating long-held assumptions that relate to the assessment and treatment of people experiencing chronic pain.…”

The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic pain

“…In Finland, 35% of adults have suffered from pain of at least three months duration, and the prevalence of daily chronic pain is 14% (Mäntyselkä, Turunen, Ahonen, & Kumpusalo, 2003). Both opioids and medical cannabis (MC) are commonly used for pain alleviation (Schlag, O'Sullivan, Zafar, & Nutt, 2021;Wertheimer et al, 2021). Opioids are known to efficiently alleviate pain both acutely and chronically (Meske et al, 2018), but they have several adverse side effects, some of them potentially fatal (Paul et al, 2021).…”