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American Academy of Neurology Issues Opioid Guidelines

Opioids for chronic noncancer pain too risky in many cases, AAN says

TUESDAY, Sept. 30, 2014 (HealthDay News) -- The risks of opioids outweigh their benefits for treating chronic noncancer pain such as chronic headaches, low back pain, and fibromyalgia, according to a new statement from the American Academy of Neurology (AAN).

According to the AAN, research indicates that while opioids may provide short-term pain relief, there is no proof that they maintain pain relief or improve patients' ability to function over long periods of time without a serious risk of overdose, dependence, or addiction.

Doctors should consult with a pain management specialist if a patient's daily opioid dosage reaches 80 milligrams to 120 milligrams, especially if the patient isn't showing substantial improvement in pain levels and physical function, the statement advises. The statement, published in the Sept. 30 issue of Neurology, also outlines ways for doctors to prescribe opioids more safely and effectively. These suggestions include: screening for depression and current and past drug abuse; creating an opioid treatment agreement with the patient; and using random urine drug screenings.

"More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use," Gary Franklin, M.D., M.P.H., of the University of Washington in Seattle, said in an academy news release. "There have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents," he added. "Doctors, states, institutions, and patients need to work together to stop this epidemic."

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