Evidence map›Paper›PMID 34849764›Full record

SynthesisFamily practice2022

Effectiveness of non-opioid interventions to reduce opioid withdrawal symptoms in patients with chronic pain: a systematic review.

Annely I Langejan, Loes de Kleijn, Hanneke J B M Rijkels-Otters, Stan F J Chudy, Alessandro Chiarotto, Bart W Koes

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Family practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Annely I LangejanDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Loes de KleijnDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.ORCID 0000-0002-8183-0529
Hanneke J B M Rijkels-OttersDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Stan F J ChudyDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Alessandro ChiarottoDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Bart W KoesDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Erasmus MC · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDealing with the opioid crisis, medical doctors are keen to learn how to best treat opioid dependency in patients with chronic non-cancer pain. Opioid replacement therapy is commonly used, but success rates vary widely. Since many patients still experience severe withdrawal symptoms, additional interventions are necessary.

objectiveTo review the effectiveness of interventions in the treatment of withdrawal symptoms during opioid tapering or acute withdrawal in patients with long-term non-cancer pain.

methodsA systematic review was conducted in Embase.com, MEDLINE, Web of Science, PsycINFO, and Cochrane CENTRAL register of trials. Studies eligible for inclusion were (non-)randomized controlled trials in adults with long-term opioid prescriptions for non-cancer pain. Included trials had to compare a non-opioid intervention to placebo, usual care, no treatment, or non-opioid drug and had to report on withdrawal symptoms as an outcome. Study quality was assessed with the 2.0 Cochrane risk of bias (RoB) tool. Evidence quality was rated following the GRADE approach.

resultsOne trial (n = 21, some concerns regarding RoB) compared Varenicline to placebo. There was no statistically significant between-group reduction of withdrawal symptoms (moderate-quality evidence).

conclusionsEvidence from clinical trials on interventions reducing withdrawal symptoms is scarce. Based on one trial with a small sample size, no firm conclusion can be drawn. Meanwhile, doctors are in dire need for therapeutic options to tackle withdrawal symptoms while tapering patients with prescription opioid dependence. We hope this review draws attention to this unfortunate research gap so that future research can provide doctors with answers.

Indexed as

Chronic PainOpioid-Related DisordersSubstance Withdrawal SyndromeAdultAnalgesics, OpioidHumansAnalgesics, Opioidchronic paininterventionsnon-opioidopioid dependencytreatmentwithdrawal symptoms

Identifiers

PMID34849764
PMCPMC9030234
OpenAlexW3216793244

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.