Who gets high-dose opioid therapy for chronic non-cancer pain?

摘要

Morasco et al. [11] in this issue of Pain provide an interesting and important window into the mystery of who receives high-dose opioid therapy for chronic non-cancer pain. The authors studied veterans receiving care in Veteran's Administration (VA) hospitals in the Pacific Northwest who received a score of at least 4/10 in pain intensity on a numerical rating scale and who received at least 90 consecutive days of opioid therapy. Since most chronic opioid use is intermittent, this study focuses on the minority of patients that use opioids on a daily basis [15]. The authors compared those receiving high-dose therapy (180 mg morphine equivalent per day or greater) to those receiving lower doses and those receiving no opioids. As might be expected for a study of veterans in the Northwest, the sample was predominantly male, white, middle-aged, overweight and had a VA service-connected disability. Because other studies suggest that females are more likely to receive chronic opioid therapy, the focus on males in this study may limit its generalizability.