[Skip to Navigation]
May 2016

Opioid Prescribing for Chronic Pain: Not for the Faint of Heart

Author Affiliations
  • 1Los Angeles County Department of Health Services, Los Angeles, California
  • 2Deputy Editor, JAMA Internal Medicine
JAMA Intern Med. 2016;176(5):599-601. doi:10.1001/jamainternmed.2016.0664

Since all drugs have adverse effects, the decision to prescribe always involves a weighing of benefits and risks. In the case of opioids prescribed for chronic pain (excluding life-threatening conditions such as cancer), we have no evidence of benefit with long-term use and much evidence of harm. However, “no evidence of benefit” is not the same as “evidence of no benefit,” especially when the patient in front of you has chronic pain and has tried nonopioid medications (eg, acetaminophen, ibuprofen) without relief or has been taking a stable dose of opioids for months or years and is asking you for a prescription.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    2 Comments for this article
    Thank you
    Dr. Michael Brown | Hazelwood family medicine
    Well written real world article
    Gregory Clanfield | Chronic Pain Patient
    Dr. Katz: I salute you for your outstanding, well thought out and common sense approach to this subject, one which is unfortunately getting too many biased, opinionated articles written about it.<br/>I cringe when reading those articles, as I believe that too many people are just taking them for the Gods truth, without giving them any thought at all.<br/>As a chronic pain patient, I can truly say that yours is a refreshing take on the subject.