We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Harm From Long-term Opioid Therapy  Comment on “Long-term Analgesic Use After Low-Risk Surgery”

Mitchell H. Katz, MD
Arch Intern Med. 2012;172(5):430. doi:10.1001/archinternmed.2011.1724.
Text Size: A A A
Published online


As part of our “Less Is More” series, the Archives has recently published several articles on the dangers of opioid use for chronic pain. In this issue of the Archives, we publish a commentary on how women may be more vulnerable to harm from long-term opioid therapy than men.1 Although all drugs have adverse effects, we are concerned about the use of opioids for chronic pain because of the lack of efficacy data for pain lasting longer than 16 weeks; the widespread use of opioids; the number of serious adverse effects, including death, attributable to opioid use; and the open question, addressed in a commentary in this issue of the Archives, as to what we are treating when we use opioids for chronic noncancer pain.2 We thought that this article was a good reminder that initiation of short-term opioid therapy may lead to their longer-term use. We should be certain with any drug we prescribe that the benefits justify the risk. In the case of this study, it is unclear why 7% of elderly persons who were not previously taking opioids should have required them for minor operations known to cause little pain or why 8% of those who received an opioid for acute pain associated with minor surgery were still taking opioids 1 year later. We believe that when it comes to opioid administration for minor surgery, among older persons, less is more.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...