{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:03:07Z","timestamp":1789398187849,"version":"build-2803163510"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100010571","name":"Bundesministerium f\u00fcr Bildung, Wissenschaft, Forschung und Technologie","doi-asserted-by":"publisher","award":["01GY2106"],"award-info":[{"award-number":["01GY2106"]}],"id":[{"id":"10.13039\/501100010571","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Drugs - Real World Outcomes"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1007\/s40801-026-00573-7","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T18:17:13Z","timestamp":1785781033000},"page":"475-486","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opioid Therapy Discontinuation in General Practice: Associations with Adjunct Therapies and Somatoform Pain Disorders"],"prefix":"10.1007","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2041-942X","authenticated-orcid":false,"given":"Sabrina","family":"Brinkm\u00f6ller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Po\u00df-Doering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Stra\u00dfner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunter","family":"Laux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"573_CR1","unstructured":"DEGAM. S1 recommendation: Chronic non-cancer pain (AWMF Register No. 053-036). Version 2025-02. Available from: https:\/\/register.awmf.org\/assets\/guidelines\/053-036l_S1_Chronischer_Schmerz_2025-02.pdf. Accessed 20 Jan 2026."},{"issue":"9","key":"573_CR2","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","volume":"161","author":"SN Raja","year":"2020","unstructured":"Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et\u00a0al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976\u201382. https:\/\/doi.org\/10.1097\/j.pain.0000000000001939.","journal-title":"Pain"},{"key":"573_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-299","volume":"9","author":"CH Friessem","year":"1991","unstructured":"Friessem CH, Willweber-Strumpf A, Zenz MW. Chronic pain in primary care. German figures from 1991 and 2006. BMC Public Health. 1991;9:299. https:\/\/doi.org\/10.1186\/1471-2458-9-299.","journal-title":"BMC Public Health"},{"issue":"4","key":"573_CR4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","volume":"10","author":"H Breivik","year":"2006","unstructured":"Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287\u2013333. https:\/\/doi.org\/10.1016\/j.ejpain.2005.06.009.","journal-title":"Eur J Pain"},{"issue":"8","key":"573_CR5","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1111\/j.1526-4637.2009.00735.x","volume":"10","author":"S Hensler","year":"2009","unstructured":"Hensler S, Heinemann D, Becker MT, Ackermann H, Wiesemann A, Abholz HH, et\u00a0al. Chronic pain in German general practice. Pain Med. 2009;10(8):1408\u201315. https:\/\/doi.org\/10.1111\/j.1526-4637.2009.00735.x.","journal-title":"Pain Med"},{"issue":"4","key":"573_CR6","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1177\/070674370805300403","volume":"53","author":"ER Tunks","year":"2008","unstructured":"Tunks ER, Crook J, Weir R. Epidemiology of chronic pain with psychological comorbidity: prevalence, risk, course, and prognosis. Can J Psychiatry. 2008;53(4):224\u201334. https:\/\/doi.org\/10.1177\/070674370805300403.","journal-title":"Can J Psychiatry"},{"key":"573_CR7","unstructured":"National Institute for Health and Care Excellence (NICE). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NG193). 2021. Available from: https:\/\/www.nice.org.uk\/guidance\/ng193. Accessed 20 Jan 2026."},{"key":"573_CR8","unstructured":"AWMF. S3 guideline: Long-term use of opioids for chronic non-cancer pain (LONTS). Version 2020-10 (AWMF Register No. 145-003). Available from: https:\/\/register.awmf.org\/assets\/guidelines\/145-003l_S3_LONTS_2020-10.pdf. Accessed 20 Jan 2026."},{"key":"573_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.23970\/AHRQEPCERTA218","volume":"218","author":"R Chou","year":"2014","unstructured":"Chou R, Deyo R, Devine B, Hansen R, Sullivan S, Jarvik JG, et\u00a0al. The effectiveness and risks of long-term opioid treatment of chronic pain. Evid Rep Technol Assess. 2014;218:1\u2013219. https:\/\/doi.org\/10.23970\/AHRQEPCERTA218.","journal-title":"Evid Rep Technol Assess"},{"issue":"23","key":"573_CR10","doi-asserted-by":"publisher","first-page":"2448","DOI":"10.1001\/jama.2018.18472","volume":"320","author":"JW Busse","year":"2018","unstructured":"Busse JW, Wang L, Kamaleldin M, et\u00a0al. Opioids for chronic noncancer pain: a systematic review and meta-analysis. JAMA. 2018;320(23):2448\u201360. https:\/\/doi.org\/10.1001\/jama.2018.18472.","journal-title":"JAMA"},{"key":"573_CR11","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1002\/ejp.1496","volume":"24","author":"P Bialas","year":"2020","unstructured":"Bialas P, Maier C, Klose P, H\u00e4user W. Efficacy and harms of long-term opioid therapy in chronic non-cancer pain: systematic review and meta-analysis of open-label extension trials with a study duration \u226526 weeks. Eur J Pain. 2020;24:265\u201378. https:\/\/doi.org\/10.1002\/ejp.1496.","journal-title":"Eur J Pain"},{"key":"573_CR12","doi-asserted-by":"publisher","unstructured":"Chou R, Hartung D, Turner J, et\u00a0al. Opioid treatments for chronic pain (Comparative Effectiveness Review No. 229). Rockville (MD): Agency for Healthcare Research and Quality; 2020. https:\/\/doi.org\/10.23970\/AHRQEPCCER229","DOI":"10.23970\/AHRQEPCCER229"},{"issue":"9","key":"573_CR13","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1001\/jama.2018.0899","volume":"319","author":"EE Krebs","year":"2018","unstructured":"Krebs EE, Gravely A, Nugent S, Jensen AC, DeRonne B, Goldsmith ES, et\u00a0al. Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain: the SPACE randomized clinical trial. JAMA. 2018;319(9):872\u201382. https:\/\/doi.org\/10.1001\/jama.2018.0899.","journal-title":"JAMA"},{"key":"573_CR14","doi-asserted-by":"publisher","unstructured":"Centers for Disease Control and Prevention. CDC clinical practice guideline for prescribing opioids for pain\u2014United States, 2022. MMWR Recomm Rep. 2022;71(3):1\u201395. https:\/\/doi.org\/10.15585\/mmwr.rr7103a1. Available from: https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/rr\/rr7103a1.htm. Accessed 20 Jan 2026.","DOI":"10.15585\/mmwr.rr7103a1"},{"issue":"7","key":"573_CR15","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1111\/bcp.14287","volume":"86","author":"M Michiels-Corsten","year":"2020","unstructured":"Michiels-Corsten M, Gerlach N, Schleef T, Junius-Walker U, Donner-Banzhoff N, Viniol A. Generic instruments for drug discontinuation in primary care: a systematic review. Br J Clin Pharmacol. 2020;86(7):1251\u201366. https:\/\/doi.org\/10.1111\/bcp.14287.","journal-title":"Br J Clin Pharmacol"},{"issue":"675","key":"573_CR16","doi-asserted-by":"publisher","first-page":"e663","DOI":"10.3399\/bjgp18X699041","volume":"68","author":"SL Thio","year":"2018","unstructured":"Thio SL, Nam J, van Driel ML, Dirven T, Blom JW. Effects of discontinuation of chronic medication in primary care: a systematic review of deprescribing trials. Br J Gen Pract. 2018;68(675):e663\u201372. https:\/\/doi.org\/10.3399\/bjgp18X699041.","journal-title":"Br J Gen Pract"},{"issue":"11","key":"573_CR17","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.1093\/pm\/pnx276","volume":"19","author":"LC Kennedy","year":"2018","unstructured":"Kennedy LC, Binswanger IA, Mueller SR, Levy C, Matlock DD, Calcaterra SL, et\u00a0al. \u201cThose conversations in my experience don\u2019t go well\u201d: a qualitative study of primary care provider experiences tapering long-term opioid medications. Pain Med. 2018;19(11):2201\u201311. https:\/\/doi.org\/10.1093\/pm\/pnx276.","journal-title":"Pain Med"},{"key":"573_CR18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-075246","volume":"13","author":"LEM Davies","year":"2023","unstructured":"Davies LEM, Koster ES, Damen KFM, et\u00a0al. Patients\u2019 perspectives on tapering programmes for prescription opioid use disorder: a qualitative study. BMJ Open. 2023;13:e075246. https:\/\/doi.org\/10.1136\/bmjopen-2023-075246.","journal-title":"BMJ Open"},{"issue":"4","key":"573_CR19","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmaf032","volume":"42","author":"S Brinkm\u00f6ller","year":"2025","unstructured":"Brinkm\u00f6ller S, Po\u00df-Doering R, Balzer A, Paul C, Wurmbach VS, Zugaj MR, et\u00a0al. Exploring opioid management challenges in chronic non-cancer pain: findings from a mixed-methods study among general practitioners in Germany. Fam Pract. 2025;42(4):cmaf032. https:\/\/doi.org\/10.1093\/fampra\/cmaf032.","journal-title":"Fam Pract"},{"issue":"10","key":"573_CR20","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.1093\/pm\/pnw078","volume":"17","author":"JW Frank","year":"2016","unstructured":"Frank JW, Levy C, Matlock DD, Calcaterra SL, Mueller SR, Koester S, et\u00a0al. Patients\u2019 perspectives on tapering of chronic opioid therapy: a qualitative study. Pain Med. 2016;17(10):1838\u201347. https:\/\/doi.org\/10.1093\/pm\/pnw078.","journal-title":"Pain Med"},{"key":"573_CR21","doi-asserted-by":"publisher","first-page":"3385","DOI":"10.2147\/JPR.S273025","volume":"13","author":"J Laigaard","year":"2020","unstructured":"Laigaard J, Bache N, Stottmeier S, Mathiesen O, Estrup S. Cognitive function during opioid tapering in patients with chronic pain: a prospective cohort study. J Pain Res. 2020;13:3385\u201394. https:\/\/doi.org\/10.2147\/JPR.S273025.","journal-title":"J Pain Res"},{"issue":"3","key":"573_CR22","doi-asserted-by":"publisher","first-page":"181","DOI":"10.7326\/M17-0598","volume":"167","author":"JW Frank","year":"2017","unstructured":"Frank JW, Lovejoy TI, Becker WC, Morasco BJ, Koenig CJ, Hoffecker L, et\u00a0al. Patient outcomes in dose reduction or discontinuation of long-term opioid therapy: a systematic review. Ann Intern Med. 2017;167(3):181\u201391. https:\/\/doi.org\/10.7326\/M17-0598.","journal-title":"Ann Intern Med"},{"issue":"11","key":"573_CR23","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1093\/pm\/pny231","volume":"20","author":"DA Fishbain","year":"2019","unstructured":"Fishbain DA, Pulikal A. Does opioid tapering in chronic pain patients result in improved pain or same pain vs increased pain at taper completion? A structured evidence-based systematic review. Pain Med. 2019;20(11):2179\u201397. https:\/\/doi.org\/10.1093\/pm\/pny231.","journal-title":"Pain Med"},{"issue":"5","key":"573_CR24","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/j.bja.2024.07.025","volume":"133","author":"E Wuyts","year":"2024","unstructured":"Wuyts E, Goudman L, Crunelle CL, Merlano Gomez M, Putman K, Bultinck F, et\u00a0al. Effectiveness of pain medication tapering in chronic pain patients: a systematic review and meta-analysis. Br J Anaesth. 2024;133(5):998\u20131020. https:\/\/doi.org\/10.1016\/j.bja.2024.07.025.","journal-title":"Br J Anaesth"},{"issue":"5","key":"573_CR25","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1001\/jama.2021.11013","volume":"326","author":"A Agnoli","year":"2021","unstructured":"Agnoli A, Xing G, Tancredi DJ, Magnan E, Jerant A, Fenton JJ. Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids. JAMA. 2021;326(5):411\u20139. https:\/\/doi.org\/10.1001\/jama.2021.11013.","journal-title":"JAMA"},{"issue":"Suppl 3","key":"573_CR26","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s11606-020-06253-8","volume":"35","author":"K Mackey","year":"2020","unstructured":"Mackey K, Anderson J, Bourne D, et\u00a0al. Benefits and harms of long-term opioid dose reduction or discontinuation in patients with chronic pain: a rapid review. J Gen Intern Med. 2020;35(Suppl 3):935\u201344. https:\/\/doi.org\/10.1007\/s11606-020-06253-8.","journal-title":"J Gen Intern Med"},{"key":"573_CR27","unstructured":"U.S. Food and Drug Administration. FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering. 2019. Available from: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires. Accessed 20 Jan 2026."},{"key":"573_CR28","unstructured":"RELIEF. Resource-oriented case management for implementing recommendations for patients with chronic pain and frequent analgesic use in general practice. 2022. Available from: https:\/\/www.relief-amed.de\/. Accessed 20 Jan 2026."},{"key":"573_CR29","unstructured":"AOK. Applying for a care grade (Pflegegrad): information on assessment and benefits. 2025. Available from: https:\/\/www.aok.de\/pk\/pflegegrad-beantragen\/. Accessed 20 Jan 2026."},{"key":"573_CR30","unstructured":"BARMER. Long-Term Care Assessment: From Points to Care Level. Wuppertal: BARMER; n.d. Available from: https:\/\/www.barmer.de\/resource\/blob\/1003084\/1f89b8f49f44b705bb9db16fde3ce69d\/barmer-vom-punktwert-zum-pflegegrad-barrierefrei-7253ep-data.pdf Accessed March 31, 2026."},{"key":"573_CR31","unstructured":"Deutsches Apotheken Portal (DAP). Abbreviations of dosage forms and their meanings (Arbeitshilfe 123). 2025. Available from: https:\/\/www.deutschesapothekenportal.de\/download\/public\/arbeitshilfen\/dap_arbeitshilfe_123.pdf. Accessed 1 Feb 2025."},{"key":"573_CR32","unstructured":"AWMF. S3 guideline: Functional bodily complaints (AWMF Register No. 051-001). 2018. Available from: https:\/\/register.awmf.org\/assets\/guidelines\/051-001l_S3_Funktionelle_Koerperbeschwerden_2018-11-abgelaufen.pdf. Accessed 20 Jan 2026."},{"issue":"4","key":"573_CR33","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s00482-013-1340-z","volume":"27","author":"W H\u00e4user","year":"2013","unstructured":"H\u00e4user W, Marschall U, L\u2019hoest H, Komossa K, Henningsen P. Administrative prevalence, treatment and costs of somatoform pain disorder: analysis of data of the BARMER GEK for the years 2008\u20132010. Schmerz. 2013;27(4):380\u20136. https:\/\/doi.org\/10.1007\/s00482-013-1340-z.","journal-title":"Schmerz"},{"issue":"8","key":"573_CR34","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0202546","volume":"13","author":"R Leutgeb","year":"2018","unstructured":"Leutgeb R, Berger S, Szecsenyi J, Laux G. Patients with somatoform disorders: more frequent attendance and higher utilization in primary out-of-hours care? PLoS ONE. 2018;13(8):e0202546. https:\/\/doi.org\/10.1371\/journal.pone.0202546.","journal-title":"PLoS ONE"},{"key":"573_CR35","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s00482-021-00582-1","volume":"36","author":"J Just","year":"2022","unstructured":"Just J, Petzke F, Scherbaum N, et\u00a0al. Critical examination of new data on the prevalence of opioid use disorders in patients with chronic pain in Germany. Schmerz. 2022;36:13\u20138. https:\/\/doi.org\/10.1007\/s00482-021-00582-1.","journal-title":"Schmerz"},{"issue":"2","key":"573_CR36","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21020180","volume":"21","author":"A Niemann","year":"2024","unstructured":"Niemann A, Schrader NF, Speckemeier C, et\u00a0al. Prescription of opioid analgesics for chronic non-cancer pain in Germany despite contraindications: administrative claims data analysis. Int J Environ Res Public Health. 2024;21(2):180. https:\/\/doi.org\/10.3390\/ijerph21020180.","journal-title":"Int J Environ Res Public Health"},{"key":"573_CR37","unstructured":"World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Geneva: World Health Organization; 2023. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240081789. Accessed 20 Jan 2026."},{"key":"573_CR38","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009790.pub2","volume":"9","author":"JA Hayden","year":"2021","unstructured":"Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9:CD009790. https:\/\/doi.org\/10.1002\/14651858.CD009790.pub2.","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"573_CR39","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.22259","volume":"7","author":"S Mak","year":"2024","unstructured":"Mak S, Allen J, Begashaw M, Miake-Lye I, Beroes-Severin J, De Vries G, et\u00a0al. Use of massage therapy for pain, 2018\u20132023: a systematic review. JAMA Netw Open. 2024;7(7):e2422259. https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.22259.","journal-title":"JAMA Netw Open"},{"issue":"1","key":"573_CR40","doi-asserted-by":"publisher","DOI":"10.1155\/prm\/2607538","volume":"2026","author":"NF Schrader","year":"2026","unstructured":"Schrader NF, Niemann A, Weitzel M, Abels C, Blase N, Neumann A, et\u00a0al. A large retrospective observational study of nonpharmacologic treatment use among German patients receiving long-term opioid therapy for chronic noncancer pain. Pain Res Manag. 2026;2026(1):e2607538. https:\/\/doi.org\/10.1155\/prm\/2607538.","journal-title":"Pain Res Manag"},{"issue":"1","key":"573_CR41","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s11606-016-3810-3","volume":"32","author":"RA Deyo","year":"2017","unstructured":"Deyo RA, Hallvik SE, Hildebran C, et\u00a0al. Association between initial opioid prescribing patterns and subsequent long-term use among opioid-na\u00efve patients: a statewide retrospective cohort study. J Gen Intern Med. 2017;32(1):21\u20137. https:\/\/doi.org\/10.1007\/s11606-016-3810-3.","journal-title":"J Gen Intern Med"},{"issue":"2","key":"573_CR42","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2024.102311","volume":"65","author":"I Ahmed","year":"2025","unstructured":"Ahmed I, Zillich AJ, Campbell NL, Sowinski KM, Foster DR. Long-term opioid therapy in older adults: incidence and risk factors related to patient characteristics and initial opioid dispensed. J Am Pharm Assoc (2003). 2025;65(2):102311. https:\/\/doi.org\/10.1016\/j.japh.2024.102311.","journal-title":"J Am Pharm Assoc (2003)"},{"key":"573_CR43","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-025-02655-2","author":"S Neusser","year":"2025","unstructured":"Neusser S, Niemann A, Schrader N, et\u00a0al. Long-term opioid prescription and opioid discontinuation in patients with chronic non-cancer pain in Germany: a retrospective analysis based on administrative claims data. J Public Health (Berl). 2025. https:\/\/doi.org\/10.1007\/s10389-025-02655-2.","journal-title":"J Public Health (Berl.)"},{"key":"573_CR44","unstructured":"AWMF. S3 guideline: Medication-related disorders (AWMF Register No. 038-025). Version 1.1. 2020. Available from: https:\/\/register.awmf.org\/assets\/guidelines\/038-025l_S3_Medikamtenbezogene-Stoerungen_2025-08-abgelaufen.pdf. Accessed 20 Jan 2026."},{"issue":"12","key":"573_CR45","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1007\/s40266-021-00893-z","volume":"38","author":"A Dufort","year":"2021","unstructured":"Dufort A, Samaan Z. Problematic opioid use among older adults: epidemiology, adverse outcomes and treatment considerations. Drugs Aging. 2021;38(12):1043\u201353. https:\/\/doi.org\/10.1007\/s40266-021-00893-z.","journal-title":"Drugs Aging"},{"issue":"2","key":"573_CR46","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.bja.2022.03.004","volume":"129","author":"J Crush","year":"2022","unstructured":"Crush J, Levy N, Knaggs RD. Misappropriation of the 1986 WHO analgesic ladder: the pitfalls of labelling opioids as weak or strong. Br J Anaesth. 2022;129(2):137\u201342. https:\/\/doi.org\/10.1016\/j.bja.2022.03.004.","journal-title":"Br J Anaesth"},{"issue":"4","key":"573_CR47","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1097\/j.pain.0000000000002423","volume":"163","author":"E Nury","year":"2022","unstructured":"Nury E, Schmucker C, Nagavci B, Motschall E, Nitschke K, Schulte E, et\u00a0al. Efficacy and safety of strong opioids for chronic noncancer pain and chronic low back pain: a systematic review and meta-analyses. Pain. 2022;163(4):610\u201336. https:\/\/doi.org\/10.1097\/j.pain.0000000000002423.","journal-title":"Pain"},{"issue":"8","key":"573_CR48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221153","volume":"14","author":"B Rosner","year":"2019","unstructured":"Rosner B, Neicun J, Yang JC, Roman-Urrestarazu A. Opioid prescription patterns in Germany and the global opioid epidemic: systematic review of available evidence. PLoS ONE. 2019;14(8):e0221153. https:\/\/doi.org\/10.1371\/journal.pone.0221153.","journal-title":"PLoS ONE"},{"issue":"5","key":"573_CR49","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1016\/S0885-3924(03)00405-6","volume":"26","author":"R Chou","year":"2003","unstructured":"Chou R, Clark E, Helfand M. Comparative efficacy and safety of long-acting oral opioids for chronic non-cancer pain: a systematic review. J Pain Symptom Manage. 2003;26(5):1026\u201348. https:\/\/doi.org\/10.1016\/S0885-3924(03)00405-6.","journal-title":"J Pain Symptom Manage"},{"issue":"4","key":"573_CR50","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/aas.12279","volume":"58","author":"L Pedersen","year":"2014","unstructured":"Pedersen L, Borchgrevink PC, Riphagen II, Fredheim OMS. Long- versus short-acting opioids. Acta Anaesthesiol Scand. 2014;58(4):390\u2013401. https:\/\/doi.org\/10.1111\/aas.12279.","journal-title":"Acta Anaesthesiol Scand"},{"issue":"Suppl 2","key":"573_CR51","doi-asserted-by":"publisher","first-page":"S79","DOI":"10.1111\/j.1526-4637.2009.00666.x","volume":"10","author":"PG Fine","year":"2009","unstructured":"Fine PG, Mahajan G, McPherson ML. Long-acting opioids and short-acting opioids: appropriate use in chronic pain management. Pain Med. 2009;10(Suppl 2):S79\u201388. https:\/\/doi.org\/10.1111\/j.1526-4637.2009.00666.x.","journal-title":"Pain Med"},{"issue":"3","key":"573_CR52","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.bja.2022.05.031","volume":"129","author":"A Noori","year":"2022","unstructured":"Noori A, Sadeghirad B, Wang L, Siemieniuk RAC, et\u00a0al. Comparative benefits and harms of individual opioids for chronic non-cancer pain: systematic review and network meta-analysis of randomised trials. Br J Anaesth. 2022;129(3):394\u2013406. https:\/\/doi.org\/10.1016\/j.bja.2022.05.031.","journal-title":"Br J Anaesth"},{"key":"573_CR53","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Kaye AM, Knezevic NN, et\u00a0al. Comprehensive, evidence-based, consensus guidelines for prescription of opioids for chronic non-cancer pain from the American Society of Interventional Pain Physicians (ASIPP). Pain Physician. 2023;26(7S):S7\u2013S126. Available from: https:\/\/www.painphysicianjournal.com\/current\/pdf?article=Nzc3Nw%3D%3D&journal=157. Accessed 20 Jan 2026.","DOI":"10.36076\/ppj.2023.26.S7"}],"container-title":["Drugs - Real World Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40801-026-00573-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40801-026-00573-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40801-026-00573-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:04:36Z","timestamp":1789394676000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40801-026-00573-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":53,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["573"],"URL":"https:\/\/doi.org\/10.1007\/s40801-026-00573-7","relation":{},"ISSN":["2199-1154","2198-9788"],"issn-type":[{"value":"2199-1154","type":"print"},{"value":"2198-9788","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"15 July 2026","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2026","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"CS and RPD share the project management in RELIEF, SB is a doctoral student in the project. CS is currently contributing to a revision of the S3-LONTS guideline. GL declares no competing interests.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study did not involve human participants. The analysis was based on claims data. The legal basis for the transfer of social data for research and planning purposes is Section 75 of the German Social Code, Book X (SGB X). The requirements of Section 75 (1) sentence 1 SGB X are met. As the project funded by the German Federal Ministry of Education and Research serves a research purpose in the public interest, the transfer of secondary data does not require individual informed consent in accordance with Article 9 (2)(j) GDPR. The pseudonymized claims data were made available following approval by the competent supervisory authority, based on an application submitted by AOK Baden\u2013W\u00fcrttemberg pursuant to Section 75 SGB X.","order":2,"name":"Ethics","label":"Ethics Approval and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}