SynthesisSchmerz (Berlin, Germany)2020
[Recommendations of the second update of the LONTS guidelines : Long-term opioid therapy for chronic noncancer pain].
Synthesis in Schmerz (Berlin, Germany), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 51 papers, 3 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
51 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- [Pain medicine aspects of the updated S2k guideline "Diagnosis and treatment of endometriosis"].Schmerz (Berlin, Germany) · 2026Guideline
- [Updated S1 guideline on long/post-COVID: relevant aspects for pain medicine].Schmerz (Berlin, Germany) · 2024Guideline
- [Do men and women respond differently to pain therapy with opioids? Results of a meta-analysis].Der Urologe. Ausg. A · 2020Pooled it
- Educating physicians on strong opioids by descriptive versus simulated-experience formats: a randomized controlled trial.BMC medical education · 2022Trial
- [Opioid use disorders during long-term opioid treatment : Risk factors and action approaches in patients with chronic nontumor pain from an outpatient medical perspective].Schmerz (Berlin, Germany) · 2026Article
- [Spinal canal stenosis : Widespread disease or just a radiological diagnosis?]Radiologie (Heidelberg, Germany) · 2026Review
- Prevalence and associated factors of opioid-related disorders among patients with chronic pain: a single-center retrospective study in a Chinese tertiary hospital.BMC anesthesiology · 2026Article
- [Spinal canal stenosis : Widespread disease or just a radiological diagnosis?]Schmerz (Berlin, Germany) · 2026Review
- Long-Acting versus Short-Acting Opioids and Opioid-Related Disorders in Chronic Non-Cancer Pain: A Claims Data Analysis in Germany.Journal of pain research · 2026Article
- Prescribing of Opioid Analgesics in Germany: Opposite Trends When Different Quantification Measures are Used.Clinical epidemiology · 2026Article
- A Large Retrospective Observational Study of Nonpharmacologic Treatment Use Among German Patients Receiving Long-Term Opioid Therapy for Chronic Noncancer Pain.Pain research & management · 2026Observational
- [Opioid prescriptions for insured individuals without cancer in Germany: data from the BARMER].Schmerz (Berlin, Germany) · 2025Article
- Patient-reported quality of outpatient healthcare in patients with chronic back or arthrosis pain with long-term opioid therapy in Germany.BMC primary care · 2025Article
- Exploring opioid management challenges in chronic non-cancer pain: findings from a mixed-methods study among general practitioners in Germany.Family practice · 2025Article
- Article
- Two-Phase Inpatient Withdrawal Programme for Long-Term Opioid Use in Non-Cancer Pain.European journal of pain (London, England) · 2025Observational
- Medication misuse and illicit substance use among palliative care patients in German palliative care units- an evaluation from the perspective of palliative care providers.Addiction science & clinical practice · 2025Article
- [Treatment of cancer-related pain-From pharmacotherapy to invasive procedures].Die Anaesthesiologie · 2025Review
- Understanding General Practitioner and Patient Perceptions Regarding Integration of Non-Pharmacological Interventions in Chronic Non-Cancer Pain Management-A Cross-Sectional Mixed-Methods Study in the RELIEF Project.Diseases (Basel, Switzerland) · 2025Article
- Exploring Physician and Patient Perspectives on Expectations and Role Models Towards Chronic Pain Treatment in General Practice: A Qualitative Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe second scheduled update of the German S3 guidelines on long-term opioid therapy for chronic noncancer pain (CNCP), the LONTS (AWMF registration number 145/003), was started in December 2018.
methodsThe guidelines were developed by 28 scientific societies and 2 patient self-help organizations under the coordination of the German Pain Society. A systematic literature search in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Scopus databases (up until December 2018) was performed. The systematic reviews with meta-analyses of randomized controlled trials with opioids for CNCP from the previous versions of the guideline were updated. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. The strength of the recommendations was established by formal multistep procedures in order to reach a consensus according to the Association of the Medical Scientific Societies in Germany (AWMF) regulations. The guidelines were reviewed by four external pain physicians. Public comments were possible for 4 weeks.
resultsOpioid-based analgesics are a drug-based treatment option for short-term (4-12 weeks), intermediate-term (13-25 weeks) and long-term (≥26 weeks) therapy of chronic osteoarthritis, diabetic polyneuropathy, postherpetic neuralgia and low back pain. Contraindications are primary headaches as well as functional somatic syndromes and mental disorders with the (cardinal) symptom pain. Based on a clinical consensus the guidelines list other medical conditions for which a therapy with opioids can be considered on an individual basis. Long-term therapy of CNCP with opioids is associated with relevant risks.
conclusionA responsible administration of opioids requires consideration of possible indications and contraindications as well as regular assessment of efficacy and adverse effects. Opioids remain a treatment option for CNCP if nonpharmacological therapies are not effective and/or other drugs are not effective, are not tolerated or are contraindicated.
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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.