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Opioids in Spine Pain: Indications, Challenges, and Controversies 

Opioids in Spine Pain: Indications, Challenges, and Controversies
Chapter:
Opioids in Spine Pain: Indications, Challenges, and Controversies
Author(s):

Puneet Sayal

, and Jianren Mao

DOI:
10.1093/med/9780199350940.003.0029
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date: 20 August 2019

Opioid medications are commonly used in the treatment of spine-mediated pain. They are used on a chronic, long-term basis, and their use is on the rise. The available evidence supports their use for short periods if much effort is put into patient and opioid selection, and with close monitoring. Challenges include numerous adverse effects, aberrant behaviors, and the comfort and skill set of providers. Controversies surrounding the chronic use of opioids center on the inconclusive evidence regarding long-term efficacy and safety. More research is necessary to determine whether these medications are appropriate, efficacious, and safe over the long term, and also to aid providers in managing patients on chronic opioids in terms of patient and opioid selection, risk stratification, monitoring, and discontinuation/weaning.

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