Sample 2: 2000
Papers published in 200026–32generally acknowledged concerns about opioid prescribing, but viewed them as a secondary concern after treating pain. For example, Quang-Cantagrel writes that the controversy about opioids “results from confusion about pathologies which could benefit from opioids and misconceptions about addiction and tolerance that may result from long-term opioid administration.”30Similarly, Watson acknowledges that “the use of opioids for neuropathic pain, generally when all else has failed, remains contentious,” but immediately goes on to write that “opioids may be the only avenue of relief for many patients with severe neuropathic pain.”32
Anesthesiology articles published in 2000 were more supportive of opioids for pain treatment (57.1%) than they were in 1991. There was common agreement that opioids can be safe and effective for short-term treatment of non-cancer pain. Yet, there continued to be uncertainty and disagreement about long-term effectiveness and risks of opioid treatment for chronic pain. Covington writes that “[w]hat we do not yet know is what the effects will be of years, in fact decades, of opioid treatment of intractable pain.”27Only Mindach took a strong stance against the index study and opioid prescribing in his commentary, claiming that “[n]ot a single convincing clinical study could be found to prove the claimed absence of addiction in pain patients.”29Of note, this article was published in a German, rather than an American or Canadian, journal.