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JAMA Insights
October 10, 2019

Pain Management With Opioids in 2019-2020

Author Affiliations
  • 1Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  • 2Durham Veterans Affairs Medical Center, Durham, North Carolina
  • 3Department of Medicine, Duke University, Durham, North Carolina
  • 4School of Medicine, University College Dublin, Belfield, Dublin, Ireland
JAMA. Published online October 10, 2019. doi:https://doi.org/10.1001/jama.2019.15802

The evidence for the management of noncancer pain among adults with acute and chronic pain conditions has evolved rapidly in recent years. Earlier recommendations and approaches resulted in more routine use of opioid analgesics.1 As a result, it has been estimated that almost 40% of US civilian, noninstitutionalized adults used prescription opioids in 2015, and prescription opioid misuse and opioid use disorder have become common.2 Coinciding with increased opioid prescribing has been a resurgence in illicit heroin use and, more recently, illicitly manufactured fentanyl. Through these combined effects, the number of estimated opioid-involved overdose deaths in the United States increased 90%, from 25 052 in 2013 to 47 600 in 2017.3

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