Inpharma 1477 - 5 Mar 2005 Concerns over opioid analgesic use in spinal pain not warranted Concerns over the development of dependence or abuse addictions "should not be used to justify the withholding of opioids from patients who have pain related to defined spinal diseases", say researchers from the US. They used prescription data for 230 patients examined in the Orthopedics Spine Clinic of the Minneapolis Veterans Affairs Medical Center between April and December 1997 to assess tolerance and dependence associated with opioid analgesic use for chronic pain. The analysis revealed that 152 patients had been prescribed opioid analgesics during the previous 3 years, and patient interview data showed that opioid analgesic use significantly reduced the severity of spinal pain. No evidence of loss of efficacy was found with longer duration of opioid treatment, suggesting that "opioid tolerance did not develop in patients treated with long- term opioids". Moreover, dosage escalations were related to progression of the underlying painful process, development of a new painful condition, or a surgical complication, in all but 3 cases, note the researchers. These data indicate that as fears over tolerance and dependence are not warranted by actual occurrence, patients with chronic spinal pain should not be "unnecessarily denied" opioid analgesic medications, they contend. Mahowald ML, et al. Opioid use by patients in an orthopedics spine clinic. Arthritis and Rheumatism 52: 312-321, No. 1, Jan 2005 801001432 1 Inpharma 5 Mar 2005 No. 1477 1173-8324/10/1477-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Concerns over opioid analgesic use in spinal pain not warranted

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Inpharma 1477 - 5 Mar 2005

Concerns over opioid analgesicuse in spinal pain not warrantedConcerns over the development of dependence or

abuse addictions "should not be used to justify thewithholding of opioids from patients who have painrelated to defined spinal diseases", say researchers fromthe US.

They used prescription data for 230 patientsexamined in the Orthopedics Spine Clinic of theMinneapolis Veterans Affairs Medical Center betweenApril and December 1997 to assess tolerance anddependence associated with opioid analgesic use forchronic pain. The analysis revealed that 152 patients hadbeen prescribed opioid analgesics during the previous 3years, and patient interview data showed that opioidanalgesic use significantly reduced the severity of spinalpain.

No evidence of loss of efficacy was found with longerduration of opioid treatment, suggesting that "opioidtolerance did not develop in patients treated with long-term opioids". Moreover, dosage escalations wererelated to progression of the underlying painful process,development of a new painful condition, or a surgicalcomplication, in all but 3 cases, note the researchers.These data indicate that as fears over tolerance anddependence are not warranted by actual occurrence,patients with chronic spinal pain should not be"unnecessarily denied" opioid analgesic medications,they contend.Mahowald ML, et al. Opioid use by patients in an orthopedics spine clinic.Arthritis and Rheumatism 52: 312-321, No. 1, Jan 2005 801001432