{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:31:53Z","timestamp":1790836313022,"version":"4.1.0"},"reference-count":33,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2019,7,18]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>An endemic increase in the number of deaths attributable to prescribed opioids is found in all developed countries. In 2016 in the USA, more than 46 people died each day from overdoses involving prescription opioids. European data show that the number of patients receiving strong opioids is increasing. In addition, there is an upsurge in hospitalisations for opioid intoxication, opioid abuse and deaths in some European countries. This class of analgesic is increasingly used in many rheumatological pathologies. Cohort studies, in various chronic non-cancer pain (CNCP) (osteoarthritis, chronic low back pain, rheumatoid arthritis, etc), show that between 2% and 8% of patients are treated with strong opioids. In order to help rheumatologists prescribe strong opioids under optimal conditions and to prevent the risk of death, abuse and misuse, recommendations have recently been published (in France in 2016, the recommendations of the French Society of Study and Treatment of Pain, in 2017, the European recommendations of the European Federation of IASP Chapters and the American Society of International Pain Physicians). They agree on the same general principles: opioids may be of interest in situations of CNCP, but their prescription must follow essential rules. It is necessary to make an accurate assessment of the pain and its origin, to formulate therapeutic objectives (pain, function and\/or quality of life), to evaluate beforehand the risk of abuse and to get a specialised opinion beyond a certain dose or duration of prescription.<\/jats:p>","DOI":"10.1136\/rmdopen-2019-001029","type":"journal-article","created":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T07:19:05Z","timestamp":1565162345000},"page":"e001029","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["The opioid epidemic: helping rheumatologists prevent a crisis"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3524-7455","authenticated-orcid":false,"given":"Anne-Priscille","family":"Trouvin","sequence":"first","affiliation":[{"name":"Centre d'Etude et Traitement de la Douleur, Hopital Ambroise-Pare, Boulogne-Billancourt, France"},{"name":"U987, INSERM, Boulogne Billancourt, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Berenbaum","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Pierre & Marie Curie Paris VI, Hopital Saint-Antoine, Paris, France"},{"name":"Universit\u00e9 Pierre & Marie Curie, Facult\u00e9 de M\u00e9decine, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Perrot","sequence":"additional","affiliation":[{"name":"U987, INSERM, Boulogne Billancourt, France"},{"name":"Centre d\u2019Evaluation et Traitement de la Douleur, Universit\u00e9 Paris Descartes, Hopital Cochin, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,6]]},"reference":[{"key":"2025090313354819000_5.2.e001029.1","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1056\/NEJMp1710756","article-title":"Drug companies\u2019 liability for the opioid epidemic","volume":"377","author":"Haffajee","year":"2017","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025090313354819000_5.2.e001029.2","unstructured":"American Academy of Pain Medicine and American Pain Society . 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