ArticlePain reports
Long-term opioid therapy for chronic noncancer pain: second update of the German guidelines.
Article in Pain reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Executive summary of the guideline for prescribing opioid analgesics for chronic non-cancer pain (third edition) by the Japan Society of Pain Clinicians.Journal of anesthesia · 2025Guideline
- Recommendations for managing adults with chronic non-cancer pain in primary care: A systematic clinical guideline review.Journal of evaluation in clinical practice · 2025Pooled it
- Health service utilization for low back pain in Germany between 2000 and 2020-a scoping review of claims data.Frontiers in pain research (Lausanne, Switzerland) · 2025Pooled it
- State of the Art in Neuromodulation or Spinal Cord Stimulation Therapy.Journal of clinical medicine · 2026Review
- A Brief Mindfulness Intervention for Pain Management in Fibromyalgia: A Single-arm Open-Label Study.Restorative neurology and neuroscience · 2026Article
- The impact of opioid prescribing guidelines on opioid dispensation: A systematic review and meta-analysis.Canadian journal of pain = Revue canadienne de la douleur · 2026Review
- 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
- Difficulties with prescribed opioids: a cross-sectional survey of primary care patients in England, United Kingdom.Pain reports · 2025Article
- Quality indicators for osteoarthritis pain management in the primary care setting.BMC musculoskeletal disorders · 2023Article
- Trends in opioid utilization in Hungary, 2006-2020: A nationwide retrospective study with multiple metrics.European journal of pain (London, England) · 2022Article
- Prevention, diagnosis, and treatment of opioid use disorder under the supervision of opioid stewardship programs: it's time to act now.The Korean journal of pain · 2022Review
- Actual situation and prescribing patterns of opioids by pain physicians in South Korea.The Korean journal of pain · 2022Article
- [Adverse effects of opioids, antidepressants and anticonvulsants on sex hormones : Often unnoticed but clinically relevant].Schmerz (Berlin, Germany) · 2022Article
- Risk Prescriptions of Strong Opioids in the Treatment of Chronic Non-Cancer Pain by Primary Care Physicians in Catalonia: Opicat Padris Project.International journal of environmental research and public health · 2022Article
- Opioid Consumption in Chronic Pain Patients: Role of Perceived Injustice and Other Psychological and Socioeconomic Factors.Journal of clinical medicine · 2022Article
- Trends in the Prescription of Strong Opioids for Chronic Non-Cancer Pain in Primary Care in Catalonia: Opicat-Padris-Project.Pharmaceutics · 2022Article
- Long-term opioid therapy for chronic noncancer pain: second update of the German guidelines.Pain reportsArticle
Corrections and comments
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Authors and funding
11 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The opioid epidemic in North America challenges national guidelines worldwide to define the importance of opioids for the management of chronic noncancer pain (CNCP).
methodsThe second update of the German guidelines on long-term opioid therapy for CNCP was developed by 26 scientific associations and 2 patient self-help organizations. A systematic literature search in CENTRAL, Medline, and Scopus (to May 2019) was performed. Meta-analyses of randomized controlled trials and open-label extension studies with opioids for CNCP were conducted. Levels of evidence were assigned according to the Oxford Centre for Evidence-Based Medicine classification system. The formulation and strength of recommendations were established by multistep formalized procedures to reach a consensus according to German Association of the Medical Scientific Societies regulations. The guidelines underwent external review by 4 experts and public commentary.
resultsOpioids are one drug-based treatment option for short- (4-12 weeks), intermediate- (13-26 weeks), and long-term (>26 weeks) therapy of chronic pain in osteoarthritis, diabetic polyneuropathy, postherpetic neuralgia, and low back pain. Contraindications are primary headaches, functional somatic syndromes, and mental disorders with the (cardinal) symptom of pain. For specified other clinical pain conditions, short- and long-term therapy with opioids should be evaluated on an individual basis. Long-term therapy with opioids is associated with relevant risks.
conclusionResponsible application of opioids requires consideration of possible indications and contraindications, as well as regular assessment of clinical response and adverse effects. Neither uncritical opioid prescription nor general rejection of opioids is justified in patients with CNCP.
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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.