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National Institutes of Health Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain by David B. Reuben, Anika A.H. Alvanzo, Takamaru Ashikaga, G. Anne Bogat, Christopher M. Callahan, Victoria Ruffing, and David C. Steffens.

Chronic pain affects an estimated 100 million Americans, or one third of the U.S. population. Approximately 25 million have moderate to severe chronic pain that limits activities and diminishes quality of life. Pain is the primary reason that Americans receive disability insurance, and societal costs are estimated at between $560 billion and $630 billion per year due to missed workdays and medical expenses.

Although there are many treatments for chronic pain, an estimated 5 to 8 million Americans use opioids for long-term management. Opioid prescriptions and use have increased dramatically over the past 20 years; the number of opioid prescriptions for pain treatment was 76 million in 1991 but reached 219 million in 2011. This striking increase has paralleled increases in opioid overdoses and treatment for addiction to prescription painkillers. Yet, evidence also indicates that 40% to 70% of persons with chronic pain do not receive proper medical treatment, with concerns for both overtreatment and undertreatment. Together, the prevalence of chronic pain and the increasing use of opioids have created a “silent epidemic” of distress, disability, and danger to a large percentage of Americans. The overriding question is: Are we, as a nation, approaching management of chronic pain in the best possible manner that maximizes effectiveness and minimizes harm?

See report here.

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