Over the last 2 years, the journal has published several articles describing the harms of long-term opioid use for chronic nonmalignant pain, especially when prescribed at high doses. For example, Gomes et al,1 in an analysis of patients who received opioid medication from the Ontario publicly funded prescription coverage program, found that patients who receive a daily dose of 20 mg of morphine or its equivalent were more likely to die of an opioid-related cause. Doses greater than 200 mg of morphine or its equivalent were associated with an almost tripling of the risk of opioid-related death compared with persons taking less than 20 mg of morphine or its equivalent.
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