Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation BlueCross BlueShield Association. Special report: chronic noncancer pain—long-term opioid benefits and harms. Chicago: BlueCross BlueShield Association (BCBS). TEC Assessment 27(1). 2012 Authors' conclusions Chronic pain is often unrelieved and undertreated and a significant patient and public health concern
with substantial costs. Many interventions hold potential benefit for CNCP including pharmacologic,
and nonpharmacologic (interventional and multidisciplinary/interdisciplinary rehabilitative). Opioids
have been shown to be effective for short-term pain relief. However, when used long-term for CNCP
and compared to other interventions, evidence to clearly define the net clinical benefit (balance of
benefits and harms) and functional outcomes is lacking.
The burden of opioid-related harms has increased substantially in recent decades. Harms affect both
treated patients and spread or spillover to individuals of all ages—from nonmedical use in adults and
adolescents to neonates experiencing abstinence syndrome or suffering from birth defects. In 2009,
there were 14,800 deaths attributed to prescription opioids—representing a 3.7-fold increase over a
decade. Existing guidelines recommend using opioids for CNCP in patients with inadequate response
to non-opioid alternatives. However, achieving a favorable balance of benefits and harms in the
setting of CNCP requires prescribing informed by the best available evidence.
Providing patients suffering from chronic pain with effective treatment is an important goal, and
many interventions are available. Opioids are but one alternative and one accompanied by potential
harms to patients and others. Given the experience with opioids, effectively relieving pain, improving
function, and minimizing harms in patients with CNCP will require concerted and coordinated efforts
of health care providers, regulatory authorities, the public and payers, together with patients. Indexing Status Subject indexing assigned by NLM MeSH Analgesics, Opioid /adverse effects /therapeutic use; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants /therapeutic use; Antidepressive Agents /therapeutic use; Blue Cross Blue Shield Insurance Plans; Chronic Disease /drug therapy; Disease Management; Evidence-Based Medicines; Pain /drug therapy /rehabilitation; Technology Assessment, Biomedical; United States Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence BlueCross BlueShield Association, Technology Evaluation Center, 225 North Michigan Ave, Chicago, Illinois, USA. Tel: 888 832 4321 Email: tec@bcbsa.com AccessionNumber 32013000447 Date abstract record published 20/06/2013 |