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Commentary| Volume 11, ISSUE 9, P830-832, September 2010

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Is Lack of Evidence the Problem?

Published:July 23, 2010DOI:https://doi.org/10.1016/j.jpain.2010.04.010
Is Lack of Evidence the Problem?
Previous ArticleOpioid Pharmacotherapy for Chronic Non-Cancer Pain in the United States: A Research Guideline for Developing an Evidence-Base
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      Whatever successes there have been for chronic opioid therapy, they are currently overshadowed by the consequences of indiscriminate prescribing. Lest anyone doubt that there is an urgent need to moderate opioid prescribing in the U.S., consider the following. Opioid prescribing in the U.S. increased 200-fold over a single decade, largely because of new prescribing for chronic pain.

      Administration Usde. Automation Of Reports And Consolidated Orders System (Arcos), Retail Drug Summary Report. Available at: http://Www.Deadiversion.Usdoj.Gov/Arcos/Retail_Drug_Summary/Index.Html

      Efforts to identify an evidence base for chronic opioid therapy revealed only that the evidence supporting effectiveness for the therapy is weak.
      • Chou R.
      • Ballantyne J.C.
      • Fanciullo G.J.
      • Fine P.G.
      • 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: 147-159
      , 
      • Chou R.
      • Fanciullo G.J.
      • Fine P.G.
      • Adler J.A.
      • Ballantyne J.C.
      • Davies P.
      • Donovan M.I.
      • Fishbain D.A.
      • Foley K.M.
      • Fudin J.
      • Gilson A.M.
      • Kelter A.
      • Mauskop A.
      • O'Connor P.G.
      • Passik S.D.
      • Pasternak G.W.
      • Portenoy R.K.
      • Rich B.A.
      • Roberts R.G.
      • Todd K.H.
      • Miaskowski C.
      Clinical Guidelines For The Use Of Chronic Opioid Therapy In Chronic Noncancer Pain.
      J Pain. 2009; 10: 113-130
      Prescription opioid abuse in the U.S. has increased in parallel, to the extent that it has overtaken illicit opioid (heroin) abuse, and is regarded by the regulatory authorities as a significant societal problem.
      • Kuehn B.M.
      Opioid Prescriptions Soar: Increase In Legitimate Use As Well As Abuse.
      Jama. 2007; 17: 249-251
      , 

      Office Of Applied Studies. National Survey On Drug Use And Health. Substance Abuse And Mental Services Administration (Samhsa) 2004. Available at: http://Wwwoassamhsagov/Nsduh/2k4nsduh/2k4results/2k4resultshtm

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        • Fine P.G.
        • 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: 147-159
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      Article info

      Publication history

      Published online: July 23, 2010

      Identification

      DOI: https://doi.org/10.1016/j.jpain.2010.04.010

      Copyright

      © 2010 Published by Elsevier Inc.

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