What are the adverse effects of prolonged opioid use in patients with chronic pain?
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Constipation, nausea, and dyspepsia are the most common long-term adverse effects of chronic opioid use (strength of recommendation [SOR]: B, systematic review of low-quality studies). Men may experience depression, fatigue, and sexual dysfunction (SOR: B, 2 observational studies). Prolonged use of opioids also may increase sensitivity to pain (SOR: C, review of case reports and case series). (This review does not address drug seeking or drug escalating.) Patients on long-term methadone are at risk for cardiac arrhythmias caused by prolonged QT intervals and torsades de pointes (SOR: C, case reports). Patients taking buprenorphine for opioid dependence may experience acute hepatitis (SOR: C, 1 case report).
Journal of Family Practice, 60(5) 2011: 288-289.