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Do people need ever-increasing doses of opioids to manage pain? (Tolerance)

Another exaggerated adverse outcome of long-term opioid therapy is the idea that patients will need ever-increasing doses of opioid pain medications due to developing tolerance.

While this does happen to some patients, the majority of people on long-term opioid therapy for chronic non-cancer pain are on stable doses, with no increases, for many years, or even decades.

The science below shows this.

Published: May 2007

Long-term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study

This study was to evaluate the outcomes associated with the use of controlled-release (CR) oxycodone for up to 3 years in the treatment of noncancer pain. It is an older study, and a small study, with only 233 participants, It is still very important, however, because there are very few long-term studies on the effects of long-term opioid therapy on chronic non-cancer pain.

This study clearly finds that for the majority of patients in this study, long-term opioid therapy provided sustained pain relief, with little need for dose increases. There were no serious side effects and the side effects waned over time. Most importantly of all, there were NO cases of addiction or overdose, which is the reason most often used for non-prescription and/or involuntary tapering of chronic non-cancer pain patients off opioids.

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