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Opioids should be considered for relief of chronic lower back pain

ROCHESTER, Minn. -- Opioid analgesics (opioids), powerful pain relievers whose use has been hotly debated in the medical community, should be prescribed for some patients with chronic lower back pain, according to a Mayo Clinic article published in the September 2002 issue of Pain Medicine, http://www.blackwellscience.com/journals/pain. After reviewing all available studies of opioid use for this condition, the author recommends that physicians and their patients at least consider opioids for the treatment of chronic, nonmalignant pain, including musculoskeletal pain and chronic lower back pain, before a patient undergoes surgery.

"Although this is somewhat controversial in that the majority of physicians still have prejudices against the use of opioid analgesics for chronic pain, there is a place for their carefully considered and closely monitored use in patients with low back pain," says J. D. Bartleson, M.D., Mayo Clinic neurologist and lead author of the paper.

Opioids are pain relievers derived from or resembling those derived from the opium plant. Well-known examples of this class of medications include morphine, oxycodone and fentanyl. The use of opioids is complicated for patients and physicians due to controversy over misuse and potential drug dependence.

"Opioids are some of the most underused drugs around because of the possibility of abuse," says Mike Joyner, M.D., Mayo Clinic anesthesiologist. "Opioids are wonderful drugs, but because of the abuse problem and moral overlay, it's hard to get a straight answer. This is because of irresponsible use by a limited number of people."

"Opioids can be a 'lifesaver' for patients with severe pain," continues Dr. Joyner. "For people with chronic pain, opioids can be like letting them out of jail."

Dr. Bartleson's article reports a dearth of randomized, controlled trials of opioid analgesic therapy for ch
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Contact: Lisa Copeland
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
3-Oct-2002


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