Annals of Internal MedicineThe Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline

In the US, chronic pain is widespread and continues to be a burden for people, families, and society as a whole. Extreme caution should be exercised when choosing to take an opioid to treat pain. The organizations do not advocate the regular use of opiate analgesics to treat chronic pain, as the hazards to the patient outweigh the minimal benefits that opioids may offer. Buprenorphine should be taken into consideration if it is decided to employ long-term opioid therapy for a patient due to its lower risk profile. By checking for underlying mental problems and a history of traumatic brain injury, clinicians can further lower the risk. Although risk mitigation strategies have been used to reduce risk in opioid patients, the guideline development group was surprised to find little evidence in this area.