Opioid misuse in gastroenterology and non-opioid management of abdominal pain.

Journal Article (Review;Journal Article)

Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction. This Review summarizes the evidence of opioid misuse in gastroenterology, including the lack of evidence of a benefit from these drugs, as well as the risk of harm and negative consequences of opioid use relative to the brain-gut axis. Guidelines for opioid management and alternative pharmacological and nonpharmacological strategies for pain management in patients with gastrointestinal disorders are also discussed. As chronic pain is complex and involves emotional and social factors, a multimodal approach targeting both pain intensity and quality of life is best.

Full Text

Duke Authors

Cited Authors

  • Szigethy, E; Knisely, M; Drossman, D

Published Date

  • March 2018

Published In

Volume / Issue

  • 15 / 3

Start / End Page

  • 168 - 180

PubMed ID

  • 29139482

Pubmed Central ID

  • 29139482

Electronic International Standard Serial Number (EISSN)

  • 1759-5053

International Standard Serial Number (ISSN)

  • 1759-5045

Digital Object Identifier (DOI)

  • 10.1038/nrgastro.2017.141


  • eng