ArticleJournal of pain research2013
Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety?
Article in Journal of pain research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 7 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
42 citing papers in PubMed, 7 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Prescribed Dose of Opioids and Overdose: A Systematic Review and Meta-Analysis of Unintentional Prescription Opioid Overdose.CNS drugs · 2018Pooled it
- Supervised dosing with a long-acting opioid medication in the management of opioid dependence.The Cochrane database of systematic reviews · 2017Pooled it
- Inhaled Cannabis for Chronic Neuropathic Pain: A Meta-analysis of Individual Patient Data.The journal of pain · 2015Pooled it
- [Opioids in chronic noncancer pain-are opioids different? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids of at least four week's duration].Schmerz (Berlin, Germany) · 2015Pooled it
- [Long-term opioid therapy in chronic noncancer pain. A systematic review and meta-analysis of efficacy, tolerability and safety in open-label extension trials with study duration of at least 26 weeks].Schmerz (Berlin, Germany) · 2015Pooled it
- [Opioids in chronic osteoarthritis pain. A systematic review and meta-analysis of efficacy, tolerability and safety in randomized placebo-controlled studies of at least 4 weeks duration].Schmerz (Berlin, Germany) · 2015Pooled it
- [Opioids in chronic low back pain. A systematic review and meta-analysis of efficacy, tolerability and safety in randomized placebo-controlled studies of at least 4 weeks duration].Schmerz (Berlin, Germany) · 2015Pooled it
- Understanding quality of life in chronic non-cancer pain: untangling the associations between medication use, psychosocial functioning, and stigma.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Buprenorphine Substitution as a Tapering Strategy for Opioid Discontinuation in Patients with Chronic Pain: A Nonrandomized and Proof of Concept Study.Pain and therapy · 2025Article
- Evaluation of the Efficacy of the Traditional Chinese Medicine Formulation Ru-Yi-Jin-Huang-Saan on Colles Fracture After Surgery: Protocol for a Randomized, Double-Blind, Placebo-Controlled Trial.JMIR research protocols · 2025Article
- Resentful, Resigned and Respectful: Opioid Analgesics, Pain and Control, a Qualitative Study.Pharmacy (Basel, Switzerland) · 2025Article
- Opioid Use Disorders: Prevention, Diagnosis, and Treatment Strategies to Mitigate Addiction Risks.Current drug safety · 2025Review
- The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review.International journal of environmental research and public health · 2024Article
- Patients' perspectives on tapering programmes for prescription opioid use disorder: a qualitative study.BMJ open · 2023Article
- Article
- Thirty-year survey of bibliometrics used in the research literature of pain: Analysis, evolution, and pitfalls.Frontiers in pain research (Lausanne, Switzerland) · 2023Review
- Low-intensity LASER and LED (photobiomodulation therapy) for pain control of the most common musculoskeletal conditions.European journal of physical and rehabilitation medicine · 2022Article
- Pain Trends Among American Adults, 2002-2018: Patterns, Disparities, and Correlates.Demography · 2021Article
- Evaluation of Self-medication for Management of Odontogenic Pain in Iranian Patients.Oral health & preventive dentistry · 2021Article
- Multiple Sclerosis and the Endogenous Opioid System.Frontiers in neuroscience · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor the past 30 years, opioids have been used to treat chronic nonmalignant pain. This study tests the following hypotheses: (1) there is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective; and (2) the main problem associated with the safety of such treatment - assessment of the risk of addiction - has been neglected.
methodsScientometric analysis of the articles representing clinical research in this area was performed to assess (1) the quality of presented evidence (type of study); and (2) the duration of the treatment phase. The sufficiency of representation of addiction was assessed by counting the number of articles that represent (1) editorials; (2) articles in the top specialty journals; and (3) articles with titles clearly indicating that the addiction-related safety is involved (topic-in-title articles).
resultsNot a single randomized controlled trial with opioid treatment lasting >3 months was found. All studies with a duration of opioid treatment ≥6 months (n = 16) were conducted without a proper control group. Such studies cannot provide the consistent good-quality evidence necessary for a strong clinical recommendation. There were profound differences in the number of addiction articles related specifically to chronic nonmalignant pain patients and to opioid addiction in general. An inadequate number of chronic pain-related publications were observed with all three types of counted articles: editorials, articles in the top specialty journals, and topic-in-title articles.
conclusionThere is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective. The above identified signs indicating neglect of addiction associated with the opioid treatment of chronic nonmalignant pain were present.
Indexed as
Identifiers
What 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.