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Editorial |

Opioid Prescribing for Chronic Pain Not for the Faint of Heart

Mitchell H. Katz, MD1,2
[+] Author Affiliations
1Los Angeles County Department of Health Services, Los Angeles, California
2Deputy Editor, JAMA Internal Medicine
JAMA Intern Med. 2016;176(5):599-601. doi:10.1001/jamainternmed.2016.0664.
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Since all drugs have adverse effects, the decision to prescribe always involves a weighing of benefits and risks. In the case of opioids prescribed for chronic pain (excluding life-threatening conditions such as cancer), we have no evidence of benefit with long-term use and much evidence of harm. However, “no evidence of benefit” is not the same as “evidence of no benefit,” especially when the patient in front of you has chronic pain and has tried nonopioid medications (eg, acetaminophen, ibuprofen) without relief or has been taking a stable dose of opioids for months or years and is asking you for a prescription.

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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.
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Submit a Comment
Thank you
Posted on March 16, 2016
Dr. Michael Brown
Hazelwood family medicine
Conflict of Interest: None Declared
Well written real world article
Excellent
Posted on March 16, 2016
Gregory Clanfield
Chronic Pain Patient
Conflict of Interest: None Declared
Dr. Katz: I salute you for your outstanding, well thought out and common sense approach to this subject, one which is unfortunately getting too many biased, opinionated articles written about it.
I cringe when reading those articles, as I believe that too many people are just taking them for the Gods truth, without giving them any thought at all.
As a chronic pain patient, I can truly say that yours is a refreshing take on the subject.
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