Guideline for Opioid Therapy and Chronic Noncancer Pain

Overview

Journal CMAJ

Date 2017 May 10

PMID 28483845

Citations 285

Authors

Jason W Busse

Samantha Craigie

David N Juurlink

D Norman Buckley

Li Wang

Rachel J Couban

Thomas Agoritsas

Elie A Akl

Alonso Carrasco-Labra

Lynn Cooper

Chris Cull

Bruno R da Costa

Joseph W Frank

Gus Grant

Alfonso Iorio

Navindra Persaud

Sol Stern

Peter Tugwell

Per Olav Vandvik

Gordon H Guyatt

Affiliations

Soon will be listed here.

Citing Articles

Difficulties with prescribed opioids: a cross-sectional survey of primary care patients in England, United Kingdom.

Wilson L, Knaggs R, Avery A, Thornley T, Moss J, Baamer R Pain Rep. 2025; 10(2):e1246.

PMID: 40012559 PMC: 11864306. DOI: 10.1097/PR9.0000000000001246.

Exploring the Pain Situation, Pain Impact, and Educational Preferences of Pain Among Adults in Mainland China, a Cross-Sectional Study.

He J, Tse M, Kwok T, Wu T, Tang S Healthcare (Basel). 2025; 13(3).

PMID: 39942478 PMC: 11817639. DOI: 10.3390/healthcare13030289.

Co-Designing a Digital Brief Intervention to Reduce the Risk of Prescription Opioid-Related Harm Among People With Chronic Noncancer Pain: Qualitative Analysis of Patient Lived Experiences.

Elphinston R, Pager S, Brown K, Sterling M, Fatehi F, Gray P JMIR Form Res. 2025; 9:e57208.

PMID: 39883931 PMC: 11826952. DOI: 10.2196/57208.

Role of Cannabis in the Management of Chronic Non-Cancer Pain: A Narrative Review.

Al-Husinat L, Obeidat S, Azzam S, Al-Gwairy Y, Obeidat F, Al Sharie S Clin Pract. 2025; 15(1).

PMID: 39851799 PMC: 11764316. DOI: 10.3390/clinpract15010016.

Barriers and enablers to opioid deprescription: A qualitative study.

Lawrence R, Versteeg E, Pike A, Etchegary H, Hall A PLoS One. 2025; 20(1):e0316730.

PMID: 39774463 PMC: 11706500. DOI: 10.1371/journal.pone.0316730.

References

Gana T, Pascual M, Fleming R, Schein J, Janagap C, Xiang J . Extended-release tramadol in the treatment of osteoarthritis: a multicenter, randomized, double-blind, placebo-controlled clinical trial. Curr Med Res Opin. 2006; 22(7):1391-401. DOI: 10.1185/030079906X115595. View

Andrews J, Guyatt G, Oxman A, Alderson P, Dahm P, Falck-Ytter Y . GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol. 2013; 66(7):719-25. DOI: 10.1016/j.jclinepi.2012.03.013. View

Busse J, Juurlink D, Guyatt G . Addressing the limitations of the CDC guideline for prescribing opioids for chronic noncancer pain. CMAJ. 2016; 188(17-18):1210-1211. PMC: 5135486. DOI: 10.1503/cmaj.161023. View

Agoritsas T, Heen A, Brandt L, Alonso-Coello P, Kristiansen A, Akl E . Decision aids that really promote shared decision making: the pace quickens. BMJ. 2015; 350:g7624. PMC: 4707568. DOI: 10.1136/bmj.g7624. View

Fernandes K, Martins D, Juurlink D, Mamdani M, Paterson J, Spooner L . High-Dose Opioid Prescribing and Opioid-Related Hospitalization: A Population-Based Study. PLoS One. 2016; 11(12):e0167479. PMC: 5156349. DOI: 10.1371/journal.pone.0167479. View

Allen M, Asbridge M, Macdougall P, Furlan A, Tugalev O . Self-reported practices in opioid management of chronic noncancer pain: a survey of Canadian family physicians. Pain Res Manag. 2013; 18(4):177-84. PMC: 3812188. DOI: 10.1155/2013/528645. View

Mangel A, Bornstein J, Hamm L, Buda J, Wang J, Irish W . Clinical trial: asimadoline in the treatment of patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2008; 28(2):239-49. DOI: 10.1111/j.1365-2036.2008.03730.x. View

Murphy Y, Goldner E, Fischer B . Prescription Opioid Use, Harms and Interventions in Canada: A Review Update of New Developments and Findings since 2010. Pain Physician. 2015; 18(4):E605-14. View

Manchikanti L, Abdi S, Atluri S, Balog C, Benyamin R, Boswell M . American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: Part 2--guidance. Pain Physician. 2012; 15(3 Suppl):S67-116. View

10.

Dowell D, Haegerich T, Chou R . CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recomm Rep. 2016; 65(1):1-49. DOI: 10.15585/mmwr.rr6501e1. View

11.

Andrews J, Schunemann H, Oxman A, Pottie K, Meerpohl J, Alonso Coello P . GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength. J Clin Epidemiol. 2013; 66(7):726-35. DOI: 10.1016/j.jclinepi.2013.02.003. View

12.

Chang Y, Zhu K, Florez I, Cho S, Zamir N, Toma A . Attitudes toward the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain: A qualitative study. J Opioid Manag. 2017; 12(6):377-387. DOI: 10.5055/jom.2016.0357. View

13.

Laine C, Taichman D, Mulrow C . Trustworthy clinical guidelines. Ann Intern Med. 2011; 154(11):774-5. DOI: 10.7326/0003-4819-154-11-201106070-00011. View

14.

Vorsanger G, Xiang J, Gana T, Pascual M, Fleming R . Extended-release tramadol (tramadol ER) in the treatment of chronic low back pain. J Opioid Manag. 2008; 4(2):87-97. DOI: 10.5055/jom.2008.0013. View

15.

Rauck R, Rapoport R, Thipphawong J . Results of a double-blind, placebo-controlled, fixed-dose assessment of once-daily OROS® hydromorphone ER in patients with moderate to severe pain associated with chronic osteoarthritis. Pain Pract. 2012; 13(1):18-29. DOI: 10.1111/j.1533-2500.2012.00555.x. View

16.

Nielsen S, Degenhardt L, Hoban B, Gisev N . A synthesis of oral morphine equivalents (OME) for opioid utilisation studies. Pharmacoepidemiol Drug Saf. 2015; 25(6):733-7. DOI: 10.1002/pds.3945. View

17.

Harden P, Ahmed S, Ang K, Wiedemer N . Clinical Implications of Tapering Chronic Opioids in a Veteran Population. Pain Med. 2015; 16(10):1975-81. DOI: 10.1111/pme.12812. View

18.

Ives T, Chelminski P, Hammett-Stabler C, Malone R, Perhac J, Potisek N . Predictors of opioid misuse in patients with chronic pain: a prospective cohort study. BMC Health Serv Res. 2006; 6:46. PMC: 1513222. DOI: 10.1186/1472-6963-6-46. View

19.

Guyatt G, Oxman A, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650):924-6. PMC: 2335261. DOI: 10.1136/bmj.39489.470347.AD. View

20.

Baron M, McDonald P . Significant pain reduction in chronic pain patients after detoxification from high-dose opioids. J Opioid Manag. 2007; 2(5):277-82. DOI: 10.5055/jom.2006.0041. View