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American Society for Action on Pain

UI - 000137

AU - Portenoy RK

TI - Chronic opioid therapy in nonmalignant pain. [Review]

AB - This review draws on data obtained in the cancer pain, nonmalignant pain, and addict populations to

examine critically the major issues raised by the use of chronic opioid therapy in nonmalignant pain. The

available evidence suggests that there is probably a selected subpopulation of patients with chronic

nonmalignant pain who may obtain sustained partial analgesia without the development of toxicity or the

psychologic and behavioral characteristics of addiction. Future discussions of this approach must adequately

define the terminology of addiction and strive to distinguish medical considerations from the societal and

regulatory influences that may affect prescribing behavior. Those who treat patients with chronic pain must

actively participate in these discussions lest decisions with enormous impact on patient care be made solely

by those whose primary responsibility is the elimination of substance abuse. [References: 114]

SO - Journal of Pain & Symptom Management 1990;5:S46-S62