Hossam El Beheiry
University of Toronto, Canada
Title: Uses and Abuses of Opioids for Chronic Non-Cancer Pain
Biography
Biography: Hossam El Beheiry
Abstract
Non-cancer chronic pain is pain lasting longer than three months or past the normal time for tissue healing not related to malignancy (Neurology 83:1277-84, 2014). Non-opioid medications were the only class of analgesics that was used for managing these conditions until the later part of 1990s. Following the recommendation of various medical authorities, various opioid compounds were used for the long term management of non-cancer chronic pain. However, such development resulted in an exponential increase in the number of prescriptions of opioids as well as an increase in the incidence of side effects and overdose related to these potent drugs. Over the last two decades, many studies particularly in the last five to seven years have been performed to investigate the efficacies and side effects of opioid therapy for non-cancer chronic pain. The purpose of this paper is to review such studies including systematic reviews, discuss the recent Canadian guidelines and evaluate the occurrence of side effects in addition to overdose and risks of long-term therapy. All relevant articles in the last five years were reviewed pertaining to the effectiveness, side effects and abuses, dosing strategies and risk assessment of opioid therapy for non-cancer chronic pain (Ann Int Med 162:276-86, 2015). The preliminary results of the review showed an equivocal evidence for long term effectiveness of opioid medications to control chronic non-cancer pain. Additionally, the preliminary results support the notion that long term opioid administration is associated with dose-dependent risk for serious side effects and abuses.
