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Position Papers
17 February 2015

National Institutes of Health Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain

Authors: David B. Reuben, MD, Anika A.H. Alvanzo, MD, MS, Takamaru Ashikaga, PhD, G. Anne Bogat, PhD, Christopher M. Callahan, MD, Victoria Ruffing, RN, CCRC, and David C. Steffens, MD, MHSAuthor, Article, & Disclosure Information
Publication: Annals of Internal Medicine
Volume 162, Number 4
https://doi.org/10.7326/M14-2775
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Abstract

This National Institutes of Health (NIH) Pathways to Prevention Workshop was cosponsored by the NIH Office of Disease Prevention (ODP), the NIH Pain Consortium, the National Institute on Drug Abuse, and the National Institute of Neurological Disorders and Stroke. A multidisciplinary working group developed the workshop agenda, and an evidence-based practice center prepared an evidence report through a contract with the Agency for Healthcare Research and Quality to facilitate the workshop discussion. During the 1.5-day workshop, invited experts discussed the body of evidence, and attendees had opportunities to provide comments during open discussion periods. After weighing evidence from the evidence report, expert presentations, and public comments, an unbiased, independent panel prepared a draft report that identified research gaps and future research priorities. The report was posted on the ODP Web site for 2 weeks for public comment. This article is an abridged version of the panel's full report, which is available at https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/opioids-chronic-pain/workshop-resources#final report.

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References

1.
Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention workshop. Ann Intern Med. 2015;162:276-86.  doi: 10.7326/M14-2559
Link
Google Scholar
2.
Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. NSDUH series H-48. HHS publication no. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014.
Google Scholar
3.
Warner M, Hedegaard H, Chen LH. NCHS Health E-Stat: Trends in Drug-poisoning Deaths Involving Opioid Analgesics and Heroin: United States, 1999–2012. Atlanta, GA: Centers for Disease Control and Prevention; 2014. Accessed at www.cdc.gov/nchs/data/hestat/drug_poisoning/drug_poisoning.htm on 22 December 2014.
Google Scholar
4.
Gomes T, Mamdani MM, Dhalla IA, Cornish S, Paterson JM, Juurlink DN. The burden of premature opioid-related mortality. Addiction. 2014;109:1482-8. [PMID: 25041316]  doi: 10.1111/add.12598
Crossref
PubMed
Google Scholar

Comments

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J Walden Retan MD 18 March 2015
Withdrawal of therapy?
“…and patients who do not meet the mutually agreed-on clinical outcomes should be considered for discontinuation of opioid therapy.”

What?

Patients come to pain clinics to get their pain reduced. Any other clinical outcome is gravy. Any other clinical outcome that is set down and identified as a therapeutic goal, to be attained or opiates will be withdrawn, isn’t “mutually agreed.” It’s coerced by a physician and tolerated by a patient who has no choice, no leverage in the negotiation.

“…many speakers agreed on the need for an ‘exit strategy’…”

Why?

Shouldn’t pain be treated as long as it’s there?

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 162 • Number 4 • 17 February 2015
Pages: 295 - 300

History

Published online: 17 February 2015
Published in issue: 17 February 2015

Keywords

  1. Cancer prevention
  2. Evidence based medicine
  3. Geriatrics
  4. Opioids
  5. Pain management
  6. Patients
  7. Psychiatry and mental health
  8. Quality of life
  9. Substance use
  10. Veteran care

Copyright

© 2015 American College of Physicians.

Authors

Affiliations

David B. Reuben, MD
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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Anika A.H. Alvanzo, MD, MS
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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Takamaru Ashikaga, PhD
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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G. Anne Bogat, PhD
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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Christopher M. Callahan, MD
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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Victoria Ruffing, RN, CCRC
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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David C. Steffens, MD, MHS
From David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Johns Hopkins University, Baltimore, Maryland; University of Vermont, Burlington, Vermont; Michigan State University, East Lansing, Michigan; Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana; and University of Connecticut Health Center, Farmington, Connecticut.
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Note: A list of the workshop panelists, speakers, working group members, and sponsors is provided in the Appendix.
Corresponding Author: David B. Reuben, MD, Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, 10945 Le Conte Avenue, Los Angeles, CA 90095.
Current Author Addresses: Dr. Reuben: Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, 10945 Le Conte Avenue, Los Angeles, CA 90095.
Dr. Alvanzo: Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 8069, Baltimore, MD 21287.
Dr. Ashikaga: University of Vermont, 105 Carrigan Drive, Medical Biostatistics, 27 Hills Building, Burlington, VT 05405.
Dr. Bogat: Department of Psychology, Michigan State University, 107E Psychology Building, East Lansing, MI 48824-1116.
Dr. Callahan: Indiana University Center for Aging Research, Regenstrief Institute, 410 West 10th Street, Building HS2000, Indianapolis, IN 46202.
Ms. Ruffing: Johns Hopkins University, 5501 Hopkins Bayview Circle, JHAAC 1B1, Baltimore, MD 21224.
Dr. Steffens: University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1410.
Author Contributions: Conception and design: D.B. Reuben, G.A. Bogat, C.M. Callahan, D.C. Steffens.
Analysis and interpretation of the data: D.B. Reuben, T. Ashikaga, G.A. Bogat.
Drafting of the article: D.B. Reuben, A.A.H. Alvanzo, T. Ashikaga, G.A. Bogat, C.M. Callahan, V. Ruffing, D.C. Steffens.
Critical revision of the article for important intellectual content: D.B. Reuben, T. Ashikaga, G.A. Bogat, C.M. Callahan, D.C. Steffens.
Final approval of the article: D.B. Reuben, A.A.H. Alvanzo, T. Ashikaga, G.A. Bogat, C.M. Callahan, V. Ruffing, D.C. Steffens.
Statistical expertise: T. Ashikaga, G.A. Bogat.
This article was published online first at www.annals.org on 13 January 2015.

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David B. Reuben, Anika A.H. Alvanzo, Takamaru Ashikaga, et al. National Institutes of Health Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain. Ann Intern Med.2015;162:295-300. [Epub 17 February 2015]. doi:10.7326/M14-2775

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