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Should opioids be used for chronic non-cancer pain?

Mark S Awerbuch
Med J Aust 2011; 195 (5): . || doi: 10.5694/mja11.10624
Published online: 5 September 2011

To the Editor: A report in the Weekend Australian earlier this year described an increase in oxycodone-associated deaths, in parallel with an increase in prescriptions for the drug, sometimes known as “hillbilly heroin”.1 These increases are likely to reflect a change in doctors’ prescribing behaviour.


  • Adelaide, SA.


Correspondence: mark@awerbuch.com.au

Competing interests:

No relevant disclosures.

  • 1. Cresswell A. Alarm over death links with opioid painkillers. Weekend Australian (Sydney) 2011; 14-15 May. http://www.theaustralian.com.au/national-affairs/alarm-over-death-links-with-opioid-painkillers/story-fn59niix-1226055613352 (accessed Jul 2011).
  • 2. Sullivan MD, Edlund MJ, Fan MY, et al. Trends in use of opioids for non-cancer pain conditions 2000–2005 in commercial and Medicaid insurance plans: the TROUP study. Pain 2008; 138: 440-449.
  • 3. Siddall PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg 2004; 99: 510-520.
  • 4. Trescot AM, Helm S, Hansen H, et al. Opioids in the management of chronic non-cancer pain: an update of American Society of the Interventional Pain Physicians’ (ASIPP) Guidelines. Pain Physician 2008; 11 (2 Suppl): S5-S62.
  • 5. Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 2009; 10: 113-130.
  • 6. Graziotti PJ, Goucke CR. The use of oral opioids in patients with chronic non-cancer pain: management strategies. Med J Aust 1997; 167: 30-34. <MJA full text>
  • 7. Victor TW, Alvarez NA, Gould E. Opioid prescribing practices in chronic pain management: guidelines do not sufficiently influence clinical practice. J Pain 2009; 10: 1051-1057.

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