Development of dependence following treatment with opioid analgesics for pain relief: a systematic review
Version of Record online: 18 OCT 2012
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Volume 108, Issue 4, pages 688–698, April 2013
How to Cite
Minozzi, S., Amato, L. and Davoli, M. (2013), Development of dependence following treatment with opioid analgesics for pain relief: a systematic review. Addiction, 108: 688–698. doi: 10.1111/j.1360-0443.2012.04005.x
- Issue online: 18 MAR 2013
- Version of Record online: 18 OCT 2012
- Accepted manuscript online: 6 JUL 2012 07:42AM EST
- Manuscript Accepted: 26 JUN 2012
- Manuscript Revised: 8 FEB 2012
- Manuscript Received: 2 DEC 2011
- WHO Department of Essential Medicines and Pharmaceutical Policies. Grant Number: 19-APW-246
- opioid analgesics;
- opioid dependence;
- pain relief;
- systematic review
To assess the incidence or prevalence of opioid dependence syndrome in adults (with and without previous history of substance abuse) following treatment with opioid analgesics for pain relief.
Medline, Embase, CINHAL and the Cochrane Library were searched up to January 2011. Systematic reviews and primary studies were included if they reported data about incidence or prevalence of opioid dependence syndrome (as defined by DSM-IV or ICD-10) in patients receiving strong opioids (or opioid-type analgesics) for treatment of acute or chronic pain due to any physical condition. The data were abstracted, and the methodological quality was assessed using validated checklists.
Data were extracted from 17 studies involving a total of 88 235 participants. The studies included three systematic reviews, one randomized controlled trial, eight cross-sectional studies and four uncontrolled case series. Most studies included adult patients with chronic non-malignant pain; two also included patients with cancer pain; only one included patients with a previous history of dependence. Incidence ranged from 0 to 24% (median 0.5%); prevalence ranged from 0 to 31% (median 4.5%).
The available evidence suggests that opioid analgesics for chronic pain conditions are not associated with a major risk for developing dependence.