Tapering Long-term Opioid Therapy in Chronic Noncancer Pain: Evidence and Recommendations for Everyday Practice.

Détails

ID Serval
serval:BIB_1C1DC3126E98
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Tapering Long-term Opioid Therapy in Chronic Noncancer Pain: Evidence and Recommendations for Everyday Practice.
Périodique
Mayo Clinic proceedings
Auteur⸱e⸱s
Berna C., Kulich R.J., Rathmell J.P.
ISSN
1942-5546 (Electronic)
ISSN-L
0025-6196
Statut éditorial
Publié
Date de publication
06/2015
Peer-reviewed
Oui
Volume
90
Numéro
6
Pages
828-842
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Résumé
Increasing concern about the risks and limited evidence supporting the therapeutic benefit of long-term opioid therapy for chronic noncancer pain are leading prescribers to consider discontinuing the use of opioids. In addition to overt addiction or diversion, the presence of adverse effects, diminishing analgesia, reduced function and quality of life, or the absence of progress toward functional goals can justify an attempt at weaning patients from long-term opioid therapy. However, discontinuing opioid therapy is often hindered by patients' psychiatric comorbidities and poor coping skills, as well as the lack of formal guidelines for the prescribers. The aim of this article is to review the existing literature and formulate recommendations for practitioners aiming to discontinue long-term opioid therapy. Specifically, this review aims to answer the following questions: What is an optimal opioid tapering regimen? How can the risks involved in a taper be managed? What are the alternatives to an opioid taper? A PubMed literature search was conducted using the keywords chronic pain combined with opioid withdrawal, taper, wean and detoxification. Six hundred ninety-five documents were identified and screened; 117 were deemed directly relevant and are included. On the base of this literature review, this article proposes evidence-based recommendations and expert-based suggestions for clinical practice. Furthermore, areas of lack of evidence are identified, providing opportunities for further research.

Mots-clé
Analgesics, Opioid/administration & dosage, Chronic Pain/drug therapy, Chronic Pain/etiology, Chronic Pain/psychology, Humans, Substance Withdrawal Syndrome/diagnosis, Substance Withdrawal Syndrome/etiology, Substance Withdrawal Syndrome/therapy
Pubmed
Web of science
Création de la notice
06/02/2018 16:27
Dernière modification de la notice
20/08/2019 12:52
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