According to a release, the new opioids guidelines were independently researched and developed for
The group noted that opioids cause an estimated 16,000 fatalities annually in the U.S. alone. The new chapter addresses critical issues surrounding opioid use and trials. Opioids are the most potent acute pain medications, yet their effectiveness for chronic pain treatment is disputed, and they are potentially addictive.
Additionally, the new opioids guidelines include a downloadable opioid treatment agreement, designed to help health care providers and patients use opioids appropriately. The opioids chapter is included in
Among the chapter's findings and recommendations:
-80-94 percent of opioid trials have industry conflicts (funding and/or conflicts of interest in the trials).
-People in safety sensitive jobs should not take opioids. A systemic review found all 12 studies of motor vehicle crashes supported an elevated risk of crashes among drivers taking opioids. Other guidelines currently on the market don't include this warning, and/or do not back it up with scientific review.
-Suggests a 50mg morphine equivalent dose is the appropriate limit. Prior guidance used elsewhere and based mostly on expert opinion has been 100-120mg, possibly allowing fatalities to occur.
-No comparative trial shows that an opioid is superior to another medication (out of 28 trials.)
-Most patients in opioid trials do not tolerate opioids and drop out in various phases of the trials.
-No evidence shows the long-term efficacy of opioids - the longest placebo controlled trial lasted only 4 months
"Patient dependence on opioids is a real and increasing problem in the U.S. We hope these new opioid guidelines provide the reliability and basis in science that will improve the way that opioids are managed, not only by health care providers, but by professionals in fields like workers comp and utilization review. It will take a broad effort and wide use of appropriate guidelines to make a real reduction in the problems caused by inappropriate use of opioids," said
The opioid recommendations in DisabilityGuidelines were developed and finalized by a multidisciplinary expert panel after review of 960 references, including 157 identified studies addressing pain treatment. In addition, 27 external peer reviewers conducted analysis of the new chapter prior to release.
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