Guideline

. 2017 May 8;189(18):E659-E666.

doi: 10.1503/cmaj.170363.

Guideline for opioid therapy and chronic noncancer pain

Jason W Busse¹, Samantha Craigie², David N Juurlink², D Norman Buckley², Li Wang², Rachel J Couban², Thomas Agoritsas², Elie A Akl², Alonso Carrasco-Labra², Lynn Cooper², Chris Cull², Bruno R da Costa², Joseph W Frank², Gus Grant², Alfonso Iorio², Navindra Persaud², Sol Stern², Peter Tugwell², Per Olav Vandvik², Gordon H Guyatt²

Affiliations

¹ The Michael G. DeGroote Institute for Pain Research and Care (Busse, Buckley, Couban, Craigie and Wang), Department of Anesthesia (Busse and Buckley), Department of Health Research Methods, Evidence, and Impact (Busse, Carrasco-Labra, Iorio and Guyatt), McMaster University, Hamilton, Ont.; University Hospitals of Geneva (Agoritsas), Geneva, Switzerland; American University of Beirut (Akl), Beirut, Lebanon; Canadian Pain Coalition (Cooper), Oshawa, Ont.; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry (Carrasco-Labra), University of Chile, Santiago, Chile; Inspire by Example, Canada (Cull); Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; VA Eastern Colorado Health Care System (Frank), Denver, Colo. and University of Colorado School of Medicine (Frank), Aurora, Colo.; College of Physicians and Surgeons of Nova Scotia (Grant), Halifax, NS; Departments of Medicine and Pediatrics (Juurlink), University of Toronto, Toronto, Ont.; Li Ka Shing Knowledge Institute (Persaud), St. Michael's Hospital, Toronto, Ont.; Argus Medical Centre (Stern), Oakville, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont.; Innlandet Hospital Trust-Division Gjøvik (Vandvik), Norway bussejw@mcmaster.ca.
² The Michael G. DeGroote Institute for Pain Research and Care (Busse, Buckley, Couban, Craigie and Wang), Department of Anesthesia (Busse and Buckley), Department of Health Research Methods, Evidence, and Impact (Busse, Carrasco-Labra, Iorio and Guyatt), McMaster University, Hamilton, Ont.; University Hospitals of Geneva (Agoritsas), Geneva, Switzerland; American University of Beirut (Akl), Beirut, Lebanon; Canadian Pain Coalition (Cooper), Oshawa, Ont.; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry (Carrasco-Labra), University of Chile, Santiago, Chile; Inspire by Example, Canada (Cull); Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; VA Eastern Colorado Health Care System (Frank), Denver, Colo. and University of Colorado School of Medicine (Frank), Aurora, Colo.; College of Physicians and Surgeons of Nova Scotia (Grant), Halifax, NS; Departments of Medicine and Pediatrics (Juurlink), University of Toronto, Toronto, Ont.; Li Ka Shing Knowledge Institute (Persaud), St. Michael's Hospital, Toronto, Ont.; Argus Medical Centre (Stern), Oakville, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont.; Innlandet Hospital Trust-Division Gjøvik (Vandvik), Norway.

PMID: 28483845
PMCID: PMC5422149
DOI: 10.1503/cmaj.170363

Guideline

Guideline for opioid therapy and chronic noncancer pain

Jason W Busse et al. CMAJ. 2017.

. 2017 May 8;189(18):E659-E666.

doi: 10.1503/cmaj.170363.

Authors

Affiliations

¹ The Michael G. DeGroote Institute for Pain Research and Care (Busse, Buckley, Couban, Craigie and Wang), Department of Anesthesia (Busse and Buckley), Department of Health Research Methods, Evidence, and Impact (Busse, Carrasco-Labra, Iorio and Guyatt), McMaster University, Hamilton, Ont.; University Hospitals of Geneva (Agoritsas), Geneva, Switzerland; American University of Beirut (Akl), Beirut, Lebanon; Canadian Pain Coalition (Cooper), Oshawa, Ont.; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry (Carrasco-Labra), University of Chile, Santiago, Chile; Inspire by Example, Canada (Cull); Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; VA Eastern Colorado Health Care System (Frank), Denver, Colo. and University of Colorado School of Medicine (Frank), Aurora, Colo.; College of Physicians and Surgeons of Nova Scotia (Grant), Halifax, NS; Departments of Medicine and Pediatrics (Juurlink), University of Toronto, Toronto, Ont.; Li Ka Shing Knowledge Institute (Persaud), St. Michael's Hospital, Toronto, Ont.; Argus Medical Centre (Stern), Oakville, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont.; Innlandet Hospital Trust-Division Gjøvik (Vandvik), Norway bussejw@mcmaster.ca.
² The Michael G. DeGroote Institute for Pain Research and Care (Busse, Buckley, Couban, Craigie and Wang), Department of Anesthesia (Busse and Buckley), Department of Health Research Methods, Evidence, and Impact (Busse, Carrasco-Labra, Iorio and Guyatt), McMaster University, Hamilton, Ont.; University Hospitals of Geneva (Agoritsas), Geneva, Switzerland; American University of Beirut (Akl), Beirut, Lebanon; Canadian Pain Coalition (Cooper), Oshawa, Ont.; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry (Carrasco-Labra), University of Chile, Santiago, Chile; Inspire by Example, Canada (Cull); Institute of Primary Health Care (da Costa), University of Bern, Bern, Switzerland; VA Eastern Colorado Health Care System (Frank), Denver, Colo. and University of Colorado School of Medicine (Frank), Aurora, Colo.; College of Physicians and Surgeons of Nova Scotia (Grant), Halifax, NS; Departments of Medicine and Pediatrics (Juurlink), University of Toronto, Toronto, Ont.; Li Ka Shing Knowledge Institute (Persaud), St. Michael's Hospital, Toronto, Ont.; Argus Medical Centre (Stern), Oakville, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont.; Innlandet Hospital Trust-Division Gjøvik (Vandvik), Norway.

PMID: 28483845
PMCID: PMC5422149
DOI: 10.1503/cmaj.170363

No abstract available

PubMed Disclaimer

Conflict of interest statement

Competing interests: D. Norm Buckley and Jason Busse report grants from Health Canada during the conduct of the study. Jason Busse received grants from the Canadian Institutes of Health Research (CIHR) during the conduct of the study. D. Norm Buckley reports grants from Purdue Pharma and Janssen Inc. outside the submitted work. Chris Cull received personal fees from Indivior. David Juurlink reports grants from CIHR and from the Ontario Ministry of Health and Long-Term Care, and personal fees outside the submitted work. Sol Stern was a member of advisory boards for Astra Zeneca, Bristol-Myers Squibb and Johnson and Johnson; received fees for expert opinions from the Canadian Medical Protective Association; received consulting fees from mdBriefCase.com, Ethypharm and Sea Courses; and received honoraria for Continuing Medical Education presentations from Purdue Pharma and Paladin. No other competing interests were declared.

Comment in

New Canadian guidance on opioid use for chronic pain: necessary but not sufficient.
Furlan AD, Williamson OD. Furlan AD, et al. CMAJ. 2017 May 8;189(18):E650-E651. doi: 10.1503/cmaj.170431. CMAJ. 2017. PMID: 28483843 Free PMC article. No abstract available.
Sensible approaches to manage the current opioid crisis.
Desapriya E, Ratnaweera K. Desapriya E, et al. CMAJ. 2017 Sep 18;189(37):E1197. doi: 10.1503/cmaj.733161. CMAJ. 2017. PMID: 28923801 Free PMC article. No abstract available.
Inconsistencies in the 2017 Canadian Guideline for Opioids for Chronic Noncancer Pain.
Weinberg EL, Baer PA. Weinberg EL, et al. CMAJ. 2017 Oct 2;189(39):E1233. doi: 10.1503/cmaj.733244. CMAJ. 2017. PMID: 28970262 Free PMC article. No abstract available.
The authors respond to "Inconsistencies in the 2017 Canadian Guideline for Opioids for Chronic Noncancer Pain".
Busse JW, Juurlink DN, Buckley DN, Guyatt GH. Busse JW, et al. CMAJ. 2017 Oct 2;189(39):E1234-E1235. doi: 10.1503/cmaj.733313. CMAJ. 2017. PMID: 28970263 Free PMC article. No abstract available.
Opioid warning label.
Herzog M. Herzog M. CMAJ. 2017 Oct 23;189(42):E1318. doi: 10.1503/cmaj.733320. CMAJ. 2017. PMID: 29061858 Free PMC article. No abstract available.
Response to "Opioid warning label".
Busse JW. Busse JW. CMAJ. 2017 Oct 23;189(42):E1319. doi: 10.1503/cmaj.733337. CMAJ. 2017. PMID: 29061859 Free PMC article. No abstract available.
The 2017 Canadian opioid guideline: already time for an overhaul.
Kahan M, Dubin R, Clarke H. Kahan M, et al. CMAJ. 2018 Mar 12;190(10):E300. doi: 10.1503/cmaj.68662. CMAJ. 2018. PMID: 29530873 Free PMC article. No abstract available.
The authors respond to "The 2017 Canadian opioid guideline: already time for an overhaul".
Busse JW, Juurlink D, Buckley DN, Guyatt GH. Busse JW, et al. CMAJ. 2018 Mar 12;190(10):E301. doi: 10.1503/cmaj.68675. CMAJ. 2018. PMID: 29530874 Free PMC article. No abstract available.

References

1. Merskey H, Bogduk NTask Force on Taxonomy of the International Association for the Study of Pain. Classification of chronic pain, second edition (revised). Seattle (WA): International Association for the Study of Pain; 1994.
1. Reitsma ML, Tranmer JE, Buchanan DM, et al. The prevalence of chronic pain and pain-related interference in the Canadian population from 1994 to 2008. Chronic Dis Inj Can 2011;31:157–64. - PubMed
1. Hogan ME, Taddio A, Katz J, et al. Health utilities in people with chronic pain using a population-level survey and linked health care administrative data. Pain 2017;158:408–16. - PubMed
1. Loeser JD. Economic implications of pain management. Acta Anaesthesiol Scand 1999;43:957–9. - PubMed
1. Lynch ME. The need for a Canadian pain strategy. Pain Res Manag 2011;16:77–80. - PMC - PubMed

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Guideline for opioid therapy and chronic noncancer pain

Affiliations

Guideline for opioid therapy and chronic noncancer pain

Authors

Affiliations

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

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Medical