(HealthDay News) — The American Academy of Neurology (AAN) has issued new guidelines for opioids use in the treatment of chronic noncancer pain, concluding that the risks of opioids use outweigh the benefits in treating chronic headaches, low back pain, and fibromyalgia.

According to the AAN, research indicates that while opioids may provide short-term pain relief, there is no proof that they maintain pain relief or improve patients’ ability to function over long periods of time without a serious risk of overdose, dependence, or addiction.

Doctors should consult with a pain management specialist if a patient’s daily opioid dosage reaches 80 milligrams to 120 milligrams, especially if the patient isn’t showing substantial improvement in pain levels and physical function, the statement advises. 

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The statement, published in an issue of Neurology, also outlines ways for doctors to prescribe opioids more safely and effectively. These suggestions include: screening for depression and current and past drug abuse; creating an opioid treatment agreement with the patient; and using random urine drug screenings.

“More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use,” Gary Franklin, MD, MPH, of the University of Washington in Seattle, said in an academy news release. “There have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents,” he added. “Doctors, states, institutions, and patients need to work together to stop this epidemic.”


  1. Franklin GM. Neurology. 2014;doi:10.1212/WNL.0000000000000839