RT Journal Article
SR Electronic
T1 Objective Evidence of Severe Disease: Opioid Use in Chronic Pain
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 366
OP 368
DO 10.1370/afm.1375
VO 10
IS 4
A1 John A. Zweifler
YR 2012
UL http://www.annfammed.org/content/10/4/366.abstract
AB Treating chronic pain presents numerous challenges. First, assessing patients with chronic pain is complicated by the lack of objective measures of pain itself. Chronic pain guidelines already developed by national organizations rely on careful history taking rather than objective measures. Second, opioids are an accepted element of chronic pain management, but their use is tempered by risks of overdose, dependency, and the potential for diversion. This essay proposes a new standard for the use of long-term opioids for chronic pain: the presence or absence of objective evidence of severe disease. This standard, which supports responsible prescribing of opioids, is one that clinicians can understand and apply when considering prescribing long-term opioids for chronic pain. Until we have measures of pain itself, we should insist upon objective evidence of severe disease before prescribing opioids for chronic pain.