GuidelineCanadian family physician Medecin de famille canadien2011
Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 1: general population.
Guideline in Canadian family physician Medecin de famille canadien, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 5 syntheses or guidelines pooled it, 179 citations in OpenAlex.
- Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.Canadian family physician Medecin de famille canadien · 2025Pooled it
- Clinical practice guidelines for the management of chronic musculoskeletal pain in primary healthcare: a systematic review.Implementation science : IS · 2017Pooled it
- Prescribing smoked cannabis for chronic noncancer pain: preliminary recommendations.Canadian family physician Medecin de famille canadien · 2014Pooled it
- Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.Annals of internal medicine · 2014Pooled it
- Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations.Canadian family physician Medecin de famille canadien · 2011Guideline
- French National Guidelines for the Appropriate Use of Opioids: Analgesia, Opioid Use Disorder, and Overdose Prevention-Part 1: Methodology and Pain Management.Pain and therapy · 2026Article
- A Survey of Knowledge, Attitudes, and Behaviours of Canadian Family Physicians in Response to the Canadian Guideline on Prescribing Opioids for Chronic Non-cancer Pain.Canadian journal of pain = Revue canadienne de la douleur · 2026Article
- Sex, gender, and sociodemographic factors associated with repeated prescription refills in chronic pain: insights from a prescription claims cohort study.Frontiers in pain research (Lausanne, Switzerland) · 2026Article
- A systematic review and meta-analysis to identify vertical limits for a high-dose opioid therapy.Neurological research and practice · 2025Review
- Trends in Drug Claims for Non-Specific Low Back Pain in Québec, 1997 to 2018.Musculoskeletal care · 2025Article
- Validation of the Nociception Level Index for the Detection of Nociception and Pain in Critically Ill Adults: Protocol for an Observational Study.JMIR research protocols · 2025Article
- Article
- Novel drugs affecting diabetic peripheral neuropathy.Iranian journal of basic medical sciences · 2024Review
- Discharge Opioid Prescription and Consumption Following Surgery: The POPCORN Observational Study.The Canadian journal of hospital pharmacy · 2024Article
- Article
- Various Doses of Tanezumab in the Management of Chronic Low Back Pain (CLBP): A Pooled Analysis of 4,514 Patients.Cureus · 2023Review
- Article
- Impact of CYP2D6 genotype on opioid use disorder deprescription: an observational prospective study in chronic pain with sex-differences.Frontiers in pharmacology · 2023Article
- Prescription Opioid Use among Patients with Chronic Noncancer Pain before and after the COVID-19 Outbreak in Taiwan: A Multicenter Prospective Observational Study.Healthcare (Basel, Switzerland) · 2022Article
- Natural history of pediatric morphine leukoencephalopathy on CT and MRI.Emergency radiology · 2022Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo provide family physicians with a practical clinical summary of the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain, developed by the National Opioid Use Guideline Group. QUALITY OF EVIDENCE: Researchers for the guideline conducted a systematic review of the literature on the effectiveness and safety of opioids for chronic noncancer pain, and drafted a series of recommendations. A panel of 49 clinicians from across Canada reviewed the draft and achieved consensus on 24 recommendations. MAIN MESSAGE: Screening for addiction risk is recommended before prescribing opioids. Weak opioids (codeine and tramadol) are recommended for mild to moderate pain that has not responded to first-line treatments. Oxycodone, hydromorphone, and morphine can be tried in patients who have not responded to weaker opioids. A low initial dose and slow upward titration is recommended, with patient education and close monitoring. Physicians should watch for the development of complications such as sleep apnea. The optimal dose is one which improves function or decreases pain ratings by at least 30%. For by far most patients, the optimal dose will be well below a 200-mg morphine equivalent dose per day. Tapering is recommended for patients who have not responded to an adequate opioid trial.
conclusionOpioids play an important role in the management of chronic noncancer pain, but careful prescribing is needed to limit potential harms. The new Canadian guideline provides much-needed guidance to help physicians achieve a balance between optimal pain control and safety.
Indexed as
Identifiers
22084455PMC3215602W2097676812What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.