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Opioid Alternatives for Pain Control: What Works, What Doesn’t

Opioid Alternatives for Pain Control: What Works, What Doesn’t

  • Oxycodone (©SteveHeap/Shutterstock.com)
    Oxycodone (©SteveHeap/Shutterstock.com)
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The Centers for Disease Control and Prevention recommends that physicians prescribe non-opioid alternatives for chronic pain, but some alternatives are more effective than others and some can be harmful. In this slideshow, we review the effectiveness and harms of nonpharmacologic and nonopioid pharmacologic treatments as described by the CDC in its 2016 opioid prescribing guidelines.

See related coverage from Rheumatology Network:

Best Practices in Prescribing Opioids for Chronic Pain

Prescribing opioids for chronic pain may be associated with some short-term efficacy, but there may be other alternatives physicians should consider.

A Review of Central Pain in Rheumatic Diseases

DMARDs and surgery are unlikely to be effective as sole therapies when central pain vs. peripheral pain is suspected in lupus, RA and osteoarthritis.

References: 

Kristine Phillips and Daniel J. Clauw. “Central pain mechanisms in the rheumatic diseases: Future directions,” Arthritis and Rheumatism. Published January 28, 2013. DOI: 0.1002/art.37739.

Deborah Dowell, Tamara Haegerich, Roger Chou. “CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016,” JAMA. Published April 19, 2016. DOI: 10.1001/jama.2016.1464

Yngvild Olsen. “The CDC Guideline on Opioid Prescribing,” JAMA. Published April 16, 2016. DOI: 10.1001/jama.2016.1910

Comments

this does not show any of the evidence for alternative agents. show me some data and cite sources.

Carl @

The quality of the evidence-base should be more closely tied to the quality of the studies from which it derives. Given the unique nature of many "chronic pain" patients with complex diagnoses -whose pain derives multiple sources - the homogenized "fits all/most" mindset can be truly harmful to the availability of person-centered care. Health insurers are quick to cut covered treatments on the basis of these promoted "guidelines" - perhaps the presentation of evidence analysis could parse the evidence in groups according to quality of studies and population variables (such as # comorbidities or pain-impact tiers)?

Cerys @

Is this a "publish or periish' article ?

Ira @

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