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Lucy Chen

, Steven P. Cohen

, and Jianren Mao

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date: 22 June 2021

Opioids have been successfully used to treat acute and chronic pain for thousands of years. For a variety of different chronic pain conditions, clinical studies have demonstrated that opioids are effective in the short-term, though only a minority of patients will obtain long-term relief, and their ability to improve function is controversial. The long-term use of opioids may be associated with significant adverse effects to include sleep and endocrine abnormalities (e.g. sexual dysfunction), psychomotor dysfunction, and opioid-induced hyperalgesia, which may paradoxically worsen pain. The incidence of frank addiction is approximately 10-20%, though up to 40% of individuals will exhibit aberrant drug-seeking behaviors. When considering chronic opioid treatment, it is important to carefully weigh the likelihood of success against the potential side effects, perform risk stratification, and continually monitor the patient for efficacy, side effects and aberrant behaviors.

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